Emerging Therapies in Cutaneous Lupus Erythematosus

Sprow, Grant; Dan, Joshua; Merola, Joseph F.; Werth, Victoria P.

doi:10.3389/fmed.2022.968323

Cited by 9 publications

(10 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although the different subtypes of CLE are united by shared pathophysiology, chronic cutaneous lupus erythematosus (CCLE)—of which discoid lupus erythematosus (DLE) constitutes the majority of cases—is distinguished by its potential to cause irreversible scarring and disfigurement . Traditional therapies including antimalarials, steroid-sparing immunosuppressive agents, retinoids, thalidomide, and lenalidomide demonstrate inconsistent success for refractory DLE . Thus, a substantial need for more effective therapies for DLE persists.…”

mentioning

confidence: 99%

Assessment of Clinical Response to Anifrolumab in Patients With Refractory Discoid Lupus Erythematosus

et al. 2023

View full text Add to dashboard Cite

show abstract

mentioning

confidence: 99%

Assessment of Clinical Response to Anifrolumab in Patients With Refractory Discoid Lupus Erythematosus

et al. 2023

View full text Add to dashboard Cite

show abstract

“…Apart from our focused approach in this review, even more drugs are under investigation for CLE or SLE. For further reading, we refer to other reviews dealing with emerging therapies in CLE or other connective tissue diseases [ 179 – 181 ].…”

Section: Treatment and Future Directionsmentioning

confidence: 99%

Cutaneous Lupus Erythematosus: An Update on Pathogenesis and Future Therapeutic Directions

et al. 2023

View full text Add to dashboard Cite

Lupus erythematosus comprises a spectrum of autoimmune diseases that may affect various organs (systemic lupus erythematosus [SLE]) or the skin only (cutaneous lupus erythematosus [CLE]). Typical combinations of clinical, histological and serological findings define clinical subtypes of CLE, yet there is high interindividual variation. Skin lesions arise in the course of triggers such as ultraviolet (UV) light exposure, smoking or drugs; keratinocytes, cytotoxic T cells and plasmacytoid dendritic cells (pDCs) establish a self-perpetuating interplay between the innate and adaptive immune system that is pivotal for the pathogenesis of CLE. Therefore, treatment relies on avoidance of triggers and UV protection, topical therapies (glucocorticosteroids, calcineurin inhibitors) and rather unspecific immunosuppressive or immunomodulatory drugs. Yet, the advent of licensed targeted therapies for SLE might also open new perspectives in the management of CLE. The heterogeneity of CLE might be attributable to individual variables and we speculate that the prevailing inflammatory signature defined by either T cells, B cells, pDCs, a strong lesional type I interferon (IFN) response, or combinations of the above might be suitable to predict therapeutic response to targeted treatment. Therefore, pretherapeutic histological assessment of the inflammatory infiltrate could stratify patients with refractory CLE for T-cell-directed therapies (e.g. dapirolizumab pegol), B-cell-directed therapies (e.g. belimumab), pDC-directed therapies (e.g. litifilimab) or IFN-directed therapies (e.g. anifrolumab). Moreover, Janus kinase (JAK) and spleen tyrosine kinase (SYK) inhibitors might broaden the therapeutic armamentarium in the near future. A close interdisciplinary exchange with rheumatologists and nephrologists is mandatory for optimal treatment of lupus patients to define the best therapeutic strategy.

show abstract

“…Поражение кожи при СКВ и ККВ часто оказывает крайне негативное влияние на качество жизни пациентов [15]. Для оценки этого влияния используется дерматологический индекс качества жизни -DLQI (Dermatology Life Quality Index), который применяется и при оценке влияния других кожных заболеваний на качество жизни пациентов (например, при псориазе, псориатическом артрите, экземе и других; приложение 3) [16,17].…”

Section: Introductionunclassified

Indexes of skin activity and damage in patients with systemic lupus erythematosus – CLASI and R-CLASI

Shumilova,

Cheldieva,

Nurbaeva

et al. 2024

Naučno-praktičeskaâ revmatologiâ

View full text Add to dashboard Cite

Introduction. Cutaneous Lupus Disease Area and Severity Index (CLASI) and its modified version, the Revised Cutaneous Lupus Erythematosus Disease Areas and Severity Index (R-CLASI) are tools for quantifying skin and mucosal lesions in patients with both cutaneous lupus erythematosus and its systemic variant. Evaluation of the scales of activity and skin damage in systemic lupus erythematosus (SLE) is associated with the need to stratify their quantitative characteristics. The Cutaneous Lupus Disease Area and Severity Index (CLASI) and its modified version the Revised Cutaneous Lupus Erythematosus Disease Area and Severity Index (R-CLASI) are a tool for quantifying skin and mucosal lesions in patients with both cutaneous lupus erythematosus (CLE) and its system version.Objective. To validate the indexes of objective assessment of skin activity and damage CLASI and R-CLASI in the Russian cohort of patients with systemic lupus erythematosus and compare it with dermatological assessments of the quality of life.Material and methods. The study included 55 patients with SLE with various types of skin and mucosal lesions, the median age was 30.0 [26.0; 40.0] years, the duration of the disease was 7.0 [3.0; 14.0] years. To assess the active (reversible) lesion and irreversible skin damage, the CLASI and R-CLASI indexes were used, for the general assessment of activity and damage in SLE, the SLEDAI-2K and SLICC/ACR DI were used.Results. The most common variant of skin lesions in patients with SLE is acute cutaneous lupus erythematosus (ACLE) – 45%, as well as alopecia, which occurs in 62% of cases. The median activity index for CLASI was 5.0 [2.0; 11.0], and R-CLASI was 7.0 [3.0; 18.0]; the median damage index for CLASI was 5.0 [2.0; 11.0], and R-CLASI was 2.0 [0.0; 7.0]. A significant relationship was revealed between the medians of CLASI and R-CLASI scores depending on the degree of activity according to SLEDAI-2K (Systemic Lupus Erythematosus Disease Activity Index) and the damage Index (DI) in SLE (SLICC/ACR DI, Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index) when recalculating these indexes only for skin and mucous lesions. According to the ROC analysis, the CLASI and R-CLASI skin activity and damage indices showed high sensitivity (CLASI activity index – 98%, R-CLASI – 93%, CLASI and R-CLASI damage index – 91%) and specificity (CLASI activity index – 64%, R-CLASI – 71%, CLASI and R-CLASI damage index – 86%).Conclusion. To assess the severity of skin and mucosal lesions in patients with SLE in the Russian Federation, it is reasonable to use the CLASI and R-CLASI indices. The CLASI and R-CLASI indices reflect the level of activity and severity of skin lesions, with higher values of these indices indicating more severe skin lesions and a significant impact on the overall well-being of SLE patients. Patients with high values of these indices often experience feelings of embarrassment, discomfort, difficulty in performing daily tasks, and limitations in social life. To assess the severity of skin and mucous lesions in patients with SLE in the Russian Federation, it is advisable to use the CLASI and R-CLASI indexes.

show abstract

Emerging Therapies in Cutaneous Lupus Erythematosus

Cited by 9 publications

References 50 publications

Assessment of Clinical Response to Anifrolumab in Patients With Refractory Discoid Lupus Erythematosus

Assessment of Clinical Response to Anifrolumab in Patients With Refractory Discoid Lupus Erythematosus

Cutaneous Lupus Erythematosus: An Update on Pathogenesis and Future Therapeutic Directions

Indexes of skin activity and damage in patients with systemic lupus erythematosus – CLASI and R-CLASI

Contact Info

Product

Resources

About