Lupus -New Hope for Lupus Disease

Lupus is an acute and chronic autoimmune disease in which the immune system is unbalanced, causing inflammation and tissue damage to virtually any organ in the body. Lupus can be unpredictable and potentially fatal, yet no satisfactory treatment or cure exists. Individuals with lupus have significantly higher rates of cardiovascular disease as well.

Systemic lupus erythematosus (SLE) is a chronic, life-threatening autoimmune disease. Approximately 5,000,000 people worldwide, including approximately 1.5 million in the United States, suffer from various forms of lupus, including SLE. Lupus can occur at any age, but appears mostly in young people ages 15 to 45. About 90 percent of those diagnosed with lupus are women. African-American women are about three times more likely to develop lupus, and it is also more common in Hispanic, Asian and American Indian women.

Lupus is a difficult disease to diagnosis as there is not specific test.   A good rheumatologist is a must if you think you might have lupus.  One of the tests they will order is the ANA blood test as 97% lupus patients are positive in this test.  They will look specifically for the following symptoms:

Common Symptoms Include:

1. Malar butterfly rash over the cheeks of the face (only affects about 15%)
2. anemia ( may be low red or white blood cells or low platelets)
3. low grade fever -over 100 degrees
4. chronic fatigue
5. arthritis - two or more tender, swollen joints of the extremities
6. kidney damage - spilling protein, red blood cells or white blood cell casts into your urine
7. pleurisy - an inflammation in the lining of your lungs which causes pain
8. pericarditis - an inflammation in the lining of your heart, also very uncomfortable
9. photosensitivity
10. alopecia -hair loss
11. Raynaud's phenomenon - an autoimmune disease affecting the circulation of blood in your fingers causing numb, purple fingers
12. Brain irritation -causing seizures
13. Mucous membrane disorders -ulcerations of the mouth or nose
14. Antinuclear antibody -positive ANA blood test

The more symptom a person has from the above list, the greater likelihood they have lupus, usually 4-7 confirm a diagnosis

It has been fifty one years since a new drug has been developed to treat lupus patients.  Lupus symptoms have been treated with such things as plaquenil, prednisone and other chemotherapy type medications.  Finally we are seeing some new drugs ready to come on the market that are less harmful and actually treat the disease.  This has been a long wait for patients who usually went a number of years without even a diagnosis.

The mission of HGS is to apply great science and great medicine to bring innovative drugs to patients with unmet medical needs. The HGS clinical development pipeline includes novel drugs to treat lupus, hepatitis C, inhalation anthrax and cancer.

Many pharmaceutical and biotechnology companies have been running dozens of clinical trials to evaluate new treatment and medications; so much progress has been achieved.  GlaxoSmithKline and Human Genome Sciences, ViforPharma, and UCB and Immunomedics, Inc. all recently reported promising results for potential new treatments for lupus.  The Lupus Foundation has announced that we are moving toward a new era in the treatment of lupus where it is a chronic but manageable disease.  The clinical trial designs have been difficult due to a number of factors but specifically it is a genetically complex disease, which means that multiple genes as well as non-genetic factors contribute to a person's risk for the disease.   More than 20 genes have been identified that influence a person's risk for lupus.

One of the new therapies that show great promise is adult stem cell transplantation.  A pilot study indicates that certain patients have achieved a sustained remission without any drugs for up to five years.  This is particularly important for those with severe disease and major organ involvement.

The Human Genome Sciences and GlaxoSmithKline have just complete phase III of a study for the new drug Benlysta.  The beneficial effects have persisted for at least 76 weeks which dates back to the beginning of the study.  The drug has been very well tolerated by patients.  How the drug works is extremely complex and I won’t attempt to explain it.  This final successful phase means the drug is almost ready for FDA approval which will make it the first lupus drug in 51 years.

The promising trial results announed by Vifor Pharma, Galencia Group, and Roche demonstrating that the drug CellCept® (mycophenolate mofetil) helps in maintaining remission of lupus nephritis.  Patients treated for up to 3 years, patients in the trial taking Cellcept (mycophenolate mofetil) went a significantly longer time without nephritis or serious renal damage or death.  This is significant as approximately 1 in 3 people with lupus develop kidney disease, and even after successful treatment the complication can still relapse.  This is not a new drug as it has been used on those who have had kidney transplants for many years.  I took this drug for approximately 3 years and my kidney function improved and I have been in a normal range ever since.  I will say this drug is great for the kidneys but it does not help with other symptoms of Lupus like arthritis, anemia, etc.

The impact of lupus on an individual and how a physician may best treat them has really been poorly understood as how to give that individual a better quality of life.  Researchers are looking at depression and stress and body image which all effect a person’s quality of life.  I will say from a personal perspective having had lupus for 27 years that stress is a huge factor.  When I am in a crisis or even just stressed I can function well and get through but about a week later I have so much joint pain that I am back on the narcotics and unable to keep up with daily chores. 

The Lupus Research Institute (LRI) National Coalition of state and local lupus organizations organizes meetings with presentations from scientist from around the world. They are a global leader in identifying bold and promising scientific hypotheses in lupus. They believe so much about this complex; difficult disease is not yet understood. They encourage researchers to think outside the box, to think creatively.

The LRI is alarmed at needed focus for children who have lupus. Children and adolescents with lupus are 2-3 times more likely than adults to develop kidney disease, central nervous system complications, and hematologic (blood) disease. Of course, with children they have the opportunity to become involved with the disease earlier on for better outcomes.

Finally, the new medication Benlysta is now available.  The results from the studies are excellent. It is given over a 2 hour period via an IV line.  Several people have been able to cut back on other medications, such as prednisone. I read in the newspaper that the medication cost $35,000 annually and that many insurance companies won't pay that amount.  That is something you would need to verify with your doctor and insurance carrier as I do not know if the newspaper was accurate. Regardless, it is the first new drug in 50 years that actually treats the disease of lupus and not just the symptoms.

There are several other drugs that are also being studied as scientist attempt to understand lupus. Stem cell therapy will probably become a major player in lupus as it is being studied with many diseases. There is hope for the future now that they finally have focused much more energy in research

The copyright to this article is owned by Pamela Oglesby. Permission to republish this article in print or online must be granted by the author in writing.