Back to Search
Start Over
Clinical Experience of Proteasome Inhibitor Bortezomib Regarding Efficacy and Safety in Severe Systemic Lupus Erythematosus: A Nationwide Study
- Source :
- Frontiers in Immunology, Frontiers in Immunology, Vol 12 (2021)
- Publication Year :
- 2021
- Publisher :
- Frontiers Media SA, 2021.
-
Abstract
- As treatment options in advanced systematic lupus erythematosus (SLE) are limited, there is an urgent need for new and effective therapeutic alternatives for selected cases with severe disease. Bortezomib (BTZ) is a specific, reversible, inhibitor of the 20S subunit of the proteasome. Herein, we report clinical experience regarding efficacy and safety from all patients receiving BTZ as therapy for SLE in Sweden during the years 2014-2020. 8 females and 4 males were included with a mean disease duration at BTZ initiation of 8.8 years (range 0.7-20 years). Renal involvement was the main target for BTZ. Reduction of global disease activity was recorded by decreasing SLEDAI-2K scores over time and remained significantly reduced at the 6-month (p=0.007) and the 12-month (p=0.008) follow-up visits. From BTZ initiation, complement protein 3 (C3) levels increased significantly after the 2(nd) treatment cycle (p=0.05), the 6-month (p=0.03) and the 12-month (p=0.04) follow-up visits. The urine albumin/creatinine ratio declined over time and reached significance at the 6-month (p=0.008) and the 12-month follow-up visits (p=0.004). Seroconversion of anti-dsDNA (27%), anti-C1q (50%) and anti-Sm (67%) was observed. 6 of 12 patients experienced at least one side-effect during follow-up, whereof the most common adverse events were infections. Safety parameters (C-reactive protein, blood cell counts) mainly remained stable over time. To conclude, we report favorable therapeutic effects of BTZ used in combination with corticosteroids in a majority of patients with severe SLE manifestations irresponsive to conventional immunosuppressive agents. Reduction of proteinuria was observed over time as well as seroconversion of some autoantibody specificities. In most patients, tolerance was acceptable but mild adverse events was not uncommon. Special attention should be paid to infections and hypogammaglobinemia. Funding Agencies|Swedish Rheumatism Association; Region Ostergotland; Gustafsson Foundation; King Gustaf Vs 80-year Anniversary foundation; King Gustaf V and Queen Victorias Freemasons foundation
- Subjects :
- Male
bortezomib (BTZ)
systemic lupus
Anti-nuclear antibody
antinuclear antibodies
Bortezomib
Adrenal Cortex Hormones
Lupus Erythematosus, Systemic
Immunology and Allergy
Child
Original Research
Proteinuria
erythematosus
Middle Aged
Lupus Nephritis
Lupus nephritis (LN)
adverse (side) effects
clinical efficacy analysis
observational study
systemic lupus - erythematosus
Antibodies, Antinuclear
Drug Therapy, Combination
Female
medicine.symptom
Proteasome Inhibitors
Immunosuppressive Agents
medicine.drug
Adult
medicine.medical_specialty
Adolescent
Immunology
Young Adult
Internal medicine
medicine
Humans
Seroconversion
Adverse effect
Rheumatology and Autoimmunity
Aged
Retrospective Studies
Sweden
Reumatologi och inflammation
Lupus erythematosus
business.industry
Therapeutic effect
Immunology in the medical area
RC581-607
medicine.disease
Immunologi inom det medicinska området
Proteasome inhibitor
Immunologic diseases. Allergy
business
Subjects
Details
- ISSN :
- 16643224
- Volume :
- 12
- Database :
- OpenAIRE
- Journal :
- Frontiers in Immunology
- Accession number :
- edsair.doi.dedup.....35d1fffa94c91f7856aa4670c679701b