Systemic Lupus Erythematosus
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Our vision for systemic lupus erythematosus
Systemic lupus erythematosus (SLE) is a chronic immune-driven disease in which the body’s immune system attacks healthy tissue in any part of the body.1 It’s experienced differently by each person and can cause a wide range of debilitating symptoms, including skin rash, joint pain, swelling and fevers.2 There have been very few new medicines for SLE, and the significant physical, emotional and
socio-economic burden remains high for people living with the disease.3,4
Our researchers are working to unlock the science of the immune system to address the significant unmet needs in lupus. By highlighting the experiences from people with SLE and investigating the underlying drivers of this complex disease, we aim to bring scientific advancements to the lupus community and challenge the boundaries they’ve had to accept for too long.
Patient portraits
Lupus affects each person differently and can be unpredictable. Hear from people with systemic lupus erythematosus (SLE) on how the disease has impacted their lives since diagnosis, and their hope for scientific advancements in the field.
Ingrid
US
Living with lupus
I was diagnosed with lupus when I was 23 and have been a Lupus Warrior for 17 years. At different points in my life, I have experienced various symptoms, including skin rash, joint pain and extreme fatigue, in addition to the emotional journey that's attached to the condition. At times these can be debilitating and it’s like a rollercoaster. There's highs, there's lows. But I’m more hopeful today than ever that scientific progress is being made to help improve the lives of people like me who are living with lupus.
Jule
Germany
Living with lupus
I was diagnosed with lupus in 2018 when I was 19. Over the last few years, I’ve experienced severe pain in my joints and connective tissues and suffered hair loss and excessive sweating. There are days when I can hardly move; there are days when I’m sad or angry, but I’ve come to accept my disease. Still, it’s important to continue raising awareness of lupus and the different treatment options. I want others living with lupus to remain hopeful for the future and remember that lupus lives with you, you do not live with lupus.
Addressing unmet needs in the lupus community
SLE is more common among those of African, Asian or Hispanic ethnicities.6 It is also estimated that 90 percent of people diagnosed with SLE are women.1
New treatments are needed to address the significant unmet medical needs faced by those living with lupus and their healthcare professionals. Patients still often have inadequate disease control, poor health-related quality of life outcomes and related health conditions. Many people with SLE rely on prolonged use of oral corticosteroids, which can be helpful in addressing increases in disease activity but can also increase the risk of organ damage and other significant side effects.3,7,8,9
Managing organ damage and more serious disease characteristics often requires more costly care.10 Across multiple countries, we found that earlier diagnosis and treatment are crucial to lowering the financial burden of SLE, and can help to reduce the risk of disease progression and flare frequency, protecting from organ damage and improving quality of life.11-15
We are continuing to follow the science to further unlock our understanding of complex immune-driven diseases like SLE. If we can recognise and address the underlying drivers of disease, we can tackle key areas of unmet need that remain.
Unlocking the science of SLE
For people living with SLE, the immune system inappropriately attacks healthy tissue in the body.1 SLE disease activity involves B, T and dendritic cells, as well as inflammatory cytokines such as type 1 interferons (IFN-1), IL-6 and B-cell activating factor. Cytokines are molecules that act as immune signallers, regulating processes along immune pathways that coordinate the overall immune response. This results in an over-activated immune response, which along with the creation of autoantibodies (antibodies formed in response to the body’s own tissues), can lead to injury, inflammation and long-term organ damage. Up to 60-80% of adults with SLE may have an elevated IFN-1 gene signature, which can be associated with increased disease severity.16-21
By understanding the role key inflammatory cytokines play in that cascade, we can begin to further unlock the complex nature of this challenging disease.
References
1. The Lupus Foundation of America. What is Lupus? Available at: http://www.lupus.org/resources/what-is-lupus. Accessed May 2023.
2. American College of Rheumatology. Guidelines for referral and management of systemic lupus erythematosus in adults. Arthritis & Rheumatology. 1999;42:1785-1796.
3. Mahieu MA, et al. A critical review of clinical trials in systemic lupus eythematosus. Lupus. 2016; 25 (10): 1122-1140
4. Merrill JT, et al. Lupus community panel proposals for optimising clinical trials: 2018. Lupus Sci Med. 2018;5:E000258
5. Al Sawah S, Daly RP, Foster SA, et al. The caregiver burden in lupus: findings from UNVEIL, a national online lupus survey in the United States. Lupus. 2017 Jan;26(1):54-61.
6. Rees F, Doherty M, Grainge MJ, et al. Worldwide incidence and prevalence of systemic lupus erythematosus: a systematic review of epidemiological studies. Rheumatology. 2017;56(11), pp. 1945-1961.
7. Harris, J, Morand, E. Editorial: Focus on Systemic Lupus Erythematosus. Front Immunol. 2016;7:400. doi: 10.3389/fimmu.2016.00400.
8. Samnaliev M, Barut V, Weir S, et al. Health Care Utilization and Costs in Adults With Systemic Lupus Erythematosus in the United Kingdom: A Real-World Observational Retrospective Cohort Study [poster]. Presented at: The European League Against Rheumatism, EULAR, European E-Congress of Rheumatology 2020; 3-6 June 2020. Abstract ID: THU0550.
9. Al Sawah S, Zhang X, Zhu B, et al. Effect of corticosteroid use by dose on the risk of developing organ damage over time in systemic lupus erythematosus—the Hopkins Lupus Cohort. Lupus Sci Med. 2015;2(1):e000066.
10. Kan HJ, Song X, Johnson BH, et al. Healthcare utilization and costs of systemic lupus erythematosus in Medicaid. Biomed Res Internat. doi:10.1155/2013/808391.
11. Nusbaum J, Mirza I, Shum J, et al. Sex Differences in Systemic Lupus Erythematosus: Epidemiology, Clinical Considerations, and Disease Pathogenesis. Mayo Clin Proc. 2020;95(2):384–394.
12. Hammond ER, Murimi IB, Lin DH, et al. Health Care Utilization and Costs of Systemic Lupus Erythematosus in the United States: A Systematic Review [poster]. Presented at: The European League Against Rheumatism, EULAR, European Congress of Rheumatology 2017; 14-17 June 2017. Abstract ID: SAT0227.
13. Murimi I, Dora L, Hong K, et al. Health Care Utililization and Costs of Systemic Lupus Erythematosus by Disease Severity in the United States. J Rheumatol. 2020;191187. doi: http://doi.org/10.3899/jrheum.
14. Hammond E, Freidel H, Garal-Pantaler E, et al. Health care resource use (hru) and medical cost analyses as a function of systemic lupus erythematosus (sle) disease severity: analysis of claims data of a german sickness fund. Lupus Sci Med. 2018;5. doi: 10.1136.
15. Yeo AL, Koelmeyer R, Kandane-Rathnayake R, et al. Lupus Low Disease Activity State is Associated with Reduced Direct Healthcare Costs in Patients with Systemic Lupus Erythematosus [published online ahead of print, 2019 Jul 8]. Arthritis Care Res (Hoboken). 2020 Sep;72(9):1289-1295.
16. Crow MK. Type I interferon in the pathogenesis of lupus. J Immunol. 2014;192(12):5459-5468.
17. Lauwerys BR, Ducreux J, Houssiau FA. Type I interferon blockade in systemic lupus erythematosus: where do we stand? Rheumatol. 2014;53(8):1369-1376.
18. Hoffman RW, Merrill JT, Alarcón-Riquelme MM, et al. Gene expression and pharmacodynamic changes in 1,760 systemic lupus erythematosus patients from two phase III trials of BAFF blockade with tabalumab. Arthritis Rheumatol. 2017;69(3):643-654.
19. Becker AM, Dao KH, Han BK, et al. SLE peripheral blood B cell, T cell and myeloid cell transcriptomes display unique profiles and each subset contributes to the interferon signature. PLoS One. 2013;8(6):e67003.
20. Jefferies CA. Regulating IRFs in IFN driven disease. Front Immunol. 2019;10:325.
21 Mai L, Asaduzzaman A, Noamani B, et al. The baseline interferon signature predicts disease severity over the subsequent 5 years in systemic lupus erythematosus. Arthritis Res Ther. 2021;23:29
Veeva ID: Z4-54681
Date of preparation: May 2023