There is, thanks to an explosion in knowledge about how cells “talk” to each other chemically in the immune system, which goes awry in SLE, or systemic lupus erythematosus. But it will be five to 10 years before a truly effective drug hits the market because a number of recent, albeit methodologically imperfect, studies, have been disappointing.
In lupus, which strikes 1.5 million Americans, mostly women, the immune system “can attack any organ” in the body, including the skin, joints, kidneys, brain, lungs and the lining of the heart, said Dr Joan Merrill [cq], medical director of the Lupus Foundation of America. Aspirin has long been used to treat lupus.
But the first prescription drugs specifically approved for lupus by the US Food and Drug Administration were the steroids, prednisone and prednisolone, and that was back in 1964. These drugs damp down the immune system, quieting lupus. But as with other immune suppressants such as Immuran, which is used in organ transplant patients, these drugs raise the risk of infection, as well as serious weight gain, acne, diabetes and bone-thinning.
Anti-malarial drugs such as Plaquenil are also approved for lupus. They quiet the immune system by acting on so-called “toll-like receptors,” said Dr. Lee Simon [cq], a rheumatologist at Beth Israel Deaconess Medical Center.
Despite the lack of a blockbuster drug, “it’s an incredibly exciting time,” Simon said, because of other drugs in the pipeline and basic research into the genetic abnormalities in lupus, in particular, a gene for alpha-interferon that might be too active in lupus patients. “The pipeline of new drugs is incredible,” said Merrill. Both Simon and Merrill consult for multiple companies making new lupus drugs.
In April, hopes were dashed when a drug called Rituxan made by Genentech and already on the market for non-Hodgkins lymphoma and rheumatoid arthritis, failed to reduce the severity of lupus. But another study of Rituxan for lupus patients whose kidneys are affected is still ongoing.
Other drugs now being tested for lupus include Riquent, Lymphostat B, Ocrelizumab, Epratusumab, Cellcept, and Orencia (already approved for rheumatoid arthritis). So, there is hope, but it’s going to take time.