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Lupus Research and Biologics

We are experiencing a lupus-treatment renaissance for new medications that might help lupus as well as other similar autoimmune inflammatory diseases.  New types of drugs, called Biologics, are creating hope as a new and effective treatment for lupus after years of no positive research news.

For instance, the drug Enbrel is a biologic.  In 1998, Enbrel was approved by the Food and Drug Administration as a treatment for rheumatoid arthritis (R.A.).  I was involved in the early studies that demonstrated the effectiveness of the drug, and I was immediately impressed with how strong and efficacious the medication was for these R.A. patients.  What does that mean? 

It means Enbrel is not made in a regular pharmaceutical factory – like Tylenol or other chemical medications – that are created from a formula, kind of like a recipe.  A biological medicine is made using living organisms.  Many of the biological medications are monoclonal antibodies.  There are a lot of copies of these antibodies that are given either by a shot (subcutaneously) into the leg or arm, or by IV (into the vein) in patients with chronic inflammatory diseases such as rheumatoid arthritis and psoriatic arthritis.   

Now, where are the new lupus biological drugs?  Well, until Benlysta (belimumab) came along and was approved recently by the FDA, no biologicals existed for the treatment of lupus.  Now, several are being researched.  Most of the studies are biologics affecting B cells.  B cells are lymphocytes that go through the bone marrow (the “B”) and acquire an ability to produce small protein antibodies.  These antibodies can be misdirected and can react with the patient’s own DNA in lupus and often produce other autoimmune antibodies that can cause tissue damage and inflammation, producing symptoms in lupus patients.  

Like any drug, these new medications can interfere with the immune system’s normal functioning and therefore could predispose patients to infection.  Infection, however, seems to be rare in these patients when compared to controls.  There is always a question that, with long-term use of these biological medications, lymphomas or other tumors such as skin cancer, could be more common in these patients.  Although a possible risk, studies have been unclear as to whether there is a significant increased chance of developing malignancies on these drugs.

Overall, the biologicals have opened up a new avenue of research and clinical development.  They can be extremely effective for inflammatory diseases and should be quite helpful for lupus.  

But the research takes a long time and is complicated and expensive.  Once approved by the FDA, the biologals can be quite costly, although pharmaceutical companies have tried their best to lower the actual cost to the consumer and have the insurance company bear most of the burden.  

One place to look for new studies if you have lupus is clinicaltrials.gov or to contact the Lupus Foundation of America, Illinois Chapter.

Two new medications being tested are called epratuzumab and another investigational drug, LY2127399, produced by the Eli Lilly Company. A cure is not around the corner, but better treatment should be available in the next few years.

I will continue to keep you updated on advances in lupus research and treatments. 
Lupus Society of Illinois
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Serving Illinois Since 1973
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