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Connective tissue diseases

Is SLE many single-organ diseases or an overlapping spectrum?

Emerging science characterizes lupus as a systemic spectrum disorder, rather than as multiple single-organ diseases. So is it time to capitalize on this progress and begin evaluating treatment options on the basis of physiologic mechanisms instead of organ involvement?

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References

  1. Muangchan, C. et al. Treatment algorithms in systemic lupus erythematosus. Arthritis Care Res. (Hoboken) http://dx.doi.org/10.1002/acr.22589.

  2. van Vollenhoven, R. F. Rituximab—shadow, illusion or light? Arthritis Res. Ther. 16, R62 (2014).

    Article  Google Scholar 

  3. Merrill, J. T. et al. Efficacy and safety of rituximab in moderately-to-severely active systemic lupus erythematosus: the randomized, double-blind, phase II/III systemic lupus erythematosus evaluation of rituximab trial. Arthritis Rheum. 62, 222–233 (2010).

    Article  CAS  Google Scholar 

  4. Rovin, B. H. et al. Efficacy and safety of rituximab in patients with active proliferative lupus nephritis: the Lupus Nephritis Assessment with Rituximab study. Arthritis Rheum. 64, 1215–1226 (2012).

    Article  CAS  Google Scholar 

  5. Condon, M. B. et al. Prospective observational single-centre cohort study to evaluate the effectiveness of treating lupus nephritis with rituximab and mycophenolate mofetil but no oral steroids. Ann. Rheum. Dis. 72, 1280–1286 (2013).

    Article  CAS  Google Scholar 

  6. Manzi, S. et al. Effects of belimumab, a B lymphocyte stimulator-specific inhibitor, on disease activity across multiple organ domains in patients with systemic lupus erythematosus: combined results from two phase III trials. Ann. Rheum. Dis. 71, 1833–1838 (2012).

    Article  CAS  Google Scholar 

  7. Brkic, Z. et al. T-helper 17 cell cytokines and interferon type I: partners in crime in systemic lupus erythematosus? Arthritis Res. Ther. 13, 228 (2011).

    Article  Google Scholar 

  8. López, P. et al. Interferon-α-induced B-lymphocyte stimulator expression and mobilization in healthy and systemic lupus erthymatosus monocytes. Rheumatology (Oxford) 53, 2249–2258 (2014).

    Article  Google Scholar 

  9. Kalunian, K. et al. Efficacy and safety of rontalizumab (anti-interferon α) in SLE subjects with restricted immunosuppressant use: results of a randomized, double-blind, placebo-controlled phase 2 study. Ann. Rheum Dis. (in press).

  10. Khamashta, M. et al. Safety and efficacy of sifalimumab, an anti IFNα monoclonal antibody, in a phase 2b study of moderate to severe systemic lupus erythematosus (SLE) [abstract]. Arthritis Rheumatol. 66 (Suppl. 10), 3531 (2014).

    Google Scholar 

Download references

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Correspondence to Joan T. Merrill.

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Competing interests

J.T.M. declares that she has acted as a consulted for Amgen, Anthera, Bristol-Myers Squibb, EMD Serono, GlaxoSmithKline, Genentech, Lilly, MedImmune, Pfizer and UCB, companies that have developed or are developing biologic treatments for lupus that are either mentioned or have overlapping mechanisms of action with the products mentioned in this commentary. J.T.M. also declares that she has received research grants from Bristol-Myers Squibb, Genentech and GlaxoSmithKline and speaker's honoraria from GlaxoSmithKline.

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Merrill, J. Is SLE many single-organ diseases or an overlapping spectrum?. Nat Rev Rheumatol 11, 385–386 (2015). https://doi.org/10.1038/nrrheum.2015.61

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