New biomarkers involved, drugs that have just been approved by regulatory agencies and important clinical trials underway that are beginning to yield surprising results… This is the scenario that, in recent times, is fueling the hope of people with lupus, a condition in which the immune system produces antibodies that attack tissues and organs such as the skin, the kidneys, the heart and the lungs, among others, to the point of being able to compromise life. Such was the case, for example, of Twin Peaks soundtrack singer Julee Cruise in June of last year.
A few months later, the media surprised with very exciting news: the first success story of CAR-T cell immunotherapy against this disease. It was about an affected young woman who had cells from her own immune system extracted to genetically modify them and reintroduce them. After this experimental treatment, applied at the University Hospital of Erlangen (Germany), the patient began to notice the remission of symptoms and even the antibodies related to the condition disappeared.
Having repeated the achievement in four other patients, an international study began at the beginning of this year in which two Spanish hospitals participated: the Vall d’Hebron in Barcelona and the Gregorio Marañón in Madrid. The expectation is served, but without forgetting the prudence that must be accompanied by any clinical trial. It is necessary to confirm results in a larger population and verify them with long-term follow-up.
Meanwhile, we must continue investigating the possible origin. Although it is known that genetic and environmental factors influence it, the cause of this autoimmune disease is still unknown and, as stated by Ana Pérez Gómez, head of the Rheumatology Section at the Hospital Príncipe de Asturias HUPA-Alcalá de Henares, “Knowing the trigger will help end the disease”. Of course, much progress has been made in recent years.
According to the specialist, apart from improving early diagnosis, “new therapeutic agents have been added and the management of the oldest ones has been improved”, which results in “changes in the prognosis and reduction in the lethality of the disease.” For example, “we are using corticosteroids less, so cardiovascular risk and infection risk are being reduced,” argues the expert. It helps a lot to have several options Biological drugs (less toxicity and fewer side effects): rituxima, belimumab or anifrolumab, the latest to join the lupus therapeutic arsenal.