New treatments of systemic lupus erythematosus

Abstract The treatment of SLE depends heavily on non-specific immune-suppressive medications. Belimumab was the first and to date the only biologic to be approved for the use of non-renal SLE. Over the last few years, several promising biologics have failed to prove their effectiveness in large phase III trials despite promising phase II data. These include molecules targeting CD22 on B cells and the interferon pathway. Currently, molecules targeting the IL23 and the Jak/STAT pathway are in phase III trials in non-renal SLE after supported by positive, albeit not impressive phase II data. In renal SLE, the preliminarily successful approach of combining the calcineurin inhibitor voclosporin and mycophenolate mofetil is currently being tested in larger trials. Besides these approaches, we also discuss promising medications that target cytokines, the complement system, co-stimulatory molecules, intracellular signaling, and are at early phases of development.