FRIDAY, Dec. 24 (HealthDay News) -- For years now, doctors have
made slow, incremental progress in the treatment of lupus, a
chronic autoimmune condition that can wrack the body and seriously
affect a person's health.
But researchers now are preparing for a potential major leap
A new medication that could be an effective new treatment for
the disease was endorsed in mid-November by an advisory panel of
the U.S. Food and Drug Administration and recommended for approval.
Though the FDA is not bound by its advisory committees'
recommendations, it usually follows them.
"There is real optimism there may be a drug approved for the treatment of lupus for the first time in 54 years," said Dr. Mary Anne Dooley, an associate professor at the University of North Carolina Kidney Center.
Lupus primarily affects women. Nine out of 10 people who have
lupus are women. It also appears to be more common among black,
Hispanic, Asian and Native American women than white women.
The disease causes the immune system to begin harming the organs
and the systems of the body. "Your immune system becomes
hyperactive, and, instead of defending you from infection, it
attacks parts of your body," Dooley said.
According to Dooley and the U.S. National Institutes of Health,
the most common symptoms of lupus include:
- A "butterfly" rash across the nose and cheeks.
- Skin rashes elsewhere.
- Skin photosensitivity.
- Joint pains and stiffness.
- Muscle aches and pain.
- Hair loss.
- Fever not linked to any other illness.
- Difficulty concentrating or remembering.
"Lupus primarily attacks the skin and the joints, but any organ can be affected," said Dr. Cynthia Aranow, an associate investigator with the Feinstein Institute for Medical Research at the North Shore-Long Island Jewish Health System in New York.
When the organs are affected, people with lupus can suffer
serious health effects. They face an increased risk for kidney
damage and other long-term health problems, and "women with lupus
are 50 times more likely to develop heart disease than women
without lupus," Dooley said.
Researchers have not yet figured out what prompts lupus. Studies
suggest that genetics probably play a large role, but there also
seems to be another factor that triggers the disease, Aranow
"We know it's more than the genes," she said. "If one twin has lupus, the risk of the other twin developing lupus is only 25 to 50 percent."
Improvements in lupus treatment have helped people live longer
and healthier lives. In 1950, a person diagnosed with lupus had a
50 percent chance of surviving two years, Aranow said. Today, the
10-year survival rate for someone with lupus very nearly mirrors
that of the overall population.
However, the improvements have not come from research
specifically targeted to lupus. The last lupus drug to receive
approval, Plaquenil, was approved in the 1950s, Dooley said.
Instead, doctors have improved lupus treatment through the use
of medications created for other diseases. "Rheumatologists beg,
borrow and steal medications from other specialties," Aranow said.
These include immunosuppressive drugs and newer anti-malarials,
anti-inflammatories and corticosteroids.
But that could change soon with Benlysta (belimumab), which has
shown promise as a lupus treatment.
Benlysta works by downregulating the communication between the
immune system's T and B cells, Dooley said. The T cells govern the
immune response and tell B cells what sort of antibodies to
"It doesn't completely prevent communication, but it reduces the hyperactivity," Dooley said. "You're still able to fight off infection and have your immune system be effective this way, but you wouldn't have all these markers of immune hyperactivity."
Benlysta has been boosted by two major studies that have come
out in the past year showing its effectiveness. And, although the
FDA had expressed concerns about safety, questioning whether its
use might be linked to depression and suicide, the advisory panel
examined safety data and decided otherwise.
At the same time, lupus researchers continue to pinch
medications and treatments from other specialties. Research is
underway to see whether an immunosuppressive drug created to
maintain kidney transplants, mycophenolate mofetil (MMF), could be
an effective lupus drug. It has become generic and, therefore, less
expensive, and it may have fewer side effects than other lupus
medications, Dooley said.
"It's important for people [with lupus] to realize that they're not alone, that the outlook is much better and there are all sorts of resources available," Aranow said.
The Lupus Foundation of America has more about
For more on lupus, read about
one woman's story.