Faced with ‘invisible illness,’ advocates vow to #MakeLupusVisible

May is Lupus Awareness Month, a time to raise awareness and educate the public on the physical, emotional and financial impact of lupus.

Systemic lupus erythematosus, the most common form of this chronic autoimmune disease, affects an estimated 200,000 Americans.

According to the CDC, 90% of lupus diagnoses are in women aged 15 to 44 years. Additionally, Black or African American and Hispanic/Latino women are more likely to develop lupus at a younger age, have more severe symptoms and are at greater risk for health complications and death.

The Lupus Foundation of America encourages supporters to bring visibility to this “invisible illness” by taking the purple pledge and posting photos on social media with the hashtags #LupusAwarenessMonth, #WorldLupusDay and #MakeLupusVisible.

To observe Lupus Awareness Month, Healio has gathered its top coverage of the latest news and research on lupus, including CAR T-cell therapy, hydroxychloroquine and lupus racial disparities.

CAR T-cell therapy brings sustained, drug-free remission in three autoimmune diseases

Single injections of CD19 chimeric antigen receptor T-cell therapy brought long-lasting remission to 15 patients with three different autoimmune diseases, according to data published in The New England Journal of Medicine.

“Although antibody-based B-cell targeting certainly improved treatment of autoimmune disease, achieving long-lasting drug-free remission has proven elusive,” Fabian Müller, MD, of the University of Erlangen-Nuremberg, in Germany, and colleagues wrote. “CAR T cells could potentially achieve this goal by deep depletion of B cells through the targeting of the surface molecule CD19, which is expressed on a wide spectrum of B cells and plasmablasts.” Read more.

FDA clears new drug application for CAR T-cell therapy in SLE with lupus nephritis

The FDA has cleared an investigational new drug application for an allogeneic anti-CD19 chimeric antigen receptor T-cell therapy for the treatment of systemic lupus erythematosus with lupus nephritis, according to the manufacturer.

The therapy, developed by Atara Biotherapeutics and currently known as ATA3219, is based on the company’s novel allogeneic Epstein-Barr virus T-cell platform and targets CD19+ relapsed or refractory B-cell malignancies. An investigational new drug application for ATA3219 was previously cleared in non-Hodgkin’s lymphoma, according to a press release from Atara. Read more.

FDA authorizes first CAR T-cell trial for children with lupus

The FDA has authorized the first chimeric antigen receptor T-cell clinical trial for children with systemic lupus erythematosus.

The trial, called Reversing Autoimmunity through Cell Therapy (REACT-01), will be led out of Seattle Children’s and is expected to launch this summer, according to a blog post from the hospital. Read more.

‘Low confidence’: Fixing the education gap for assessing lupus lesions in Black patients

Black patients have a three- to five-fold increased incidence of primary chronic cutaneous lupus vs. white patients, but are often completely missing from training materials and most images of cutaneous lupus rashes online.

This lack of proper representation can result in material, adverse consequences for many patients. For example, a paper published in Arthritis Care & Research by Tinianow and colleagues reported that many rheumatologists report “low confidence” in assessing cutaneous lupus erythematosus lesions, particularly those in patients who identify as Black, Indigenous or people of color. These patients are “historically excluded from educational materials,” they wrote. Read more.

First-trimester hydroxychloroquine use adds no significant risk for birth defects

Hydroxychloroquine use for systemic lupus erythematosus or rheumatoid arthritis in the first trimester of pregnancy does not significantly increase the risk for major congenital malformations, according to data published in Rheumatology.

“Hydroxychloroquine has long been recommended and used for pregnant individuals with rheumatic diseases, including systemic lupus and rheumatoid arthritis,” Ngoc V. Nguyen, MSc, a PhD candidate at the Karolinska Institute, in Sweden, told Healio. Read more.

Yearly depression, physical function screening recommended for all patients with lupus

Depression and physical function should be assessed at least once per year in all patients with systemic lupus erythematosus, according to recommended quality measures devised by an American College of Rheumatology workgroup.

“Despite significant progress in the pharmacological management of SLE, there remains a need to understand and address the patient experience of illness more fully, particularly as there is often discordance between physician and patient assessments of disease,” Patricia P. Katz, PhD, of the University of California, San Francisco, Claire E.H. Barber, MD, PhD, FRCPC, of the University of Calgary, and colleagues wrote in Arthritis Care & Research. “One important strategy for gaining this understanding is using standardized patient-reported outcomes.” Read more.

Vaccines do not increase risk for lupus, meta-analysis finds

Vaccinations in general do not increase the risk for systemic lupus erythematosus, but hepatitis B vaccines may have a “significant connection” with the disease, according to a meta-analysis published in Arthritis Research & Therapy.

“Vaccinations have been theorized as potential triggers for the onset of SLE, considering their role in eliciting antigen-specific immune responses,” Meijiao Wang, of Zhejiang Chinese Medical University, and colleagues wrote. Read more.

References:

Lupus Awareness Month. Lupus Foundation of America. https://www.lupus.org/lupus-awareness-month. Accessed April 26, 2024.

Women’s Unseen Battle: Shining a Light on Lupus. CDC. https://www.cdc.gov/healthequity/features/lupus/index.html. Published May 25, 2023. Accessed April 26, 2024.