[Allergo-immunology. Clinical immunology]

Area of Science:

• Clinical Immunology
• Rheumatology
• Immunosuppressive Therapy

Background:

• Systemic lupus erythematosus (SLE) and ANCA-associated vasculitis are complex autoimmune diseases.
• Managing refractory SLE and severe lupus nephritis presents significant clinical challenges.
• Identifying effective and safe therapeutic alternatives is crucial for improving patient outcomes.

Purpose of the Study:

• To review recent advancements in the clinical management of autoimmune diseases.
• To highlight novel therapeutic strategies for systemic lupus erythematosus (SLE).
• To assess the efficacy of new treatments for lupus nephritis and ANCA-associated vasculitis.

Main Methods:

• Review of key clinical trial results from the past year.
• Analysis of data from the BLISS 52, ALMS, RAVE, and RITUXVASC studies.
• Evaluation of treatment efficacy in patients with refractory SLE, lupus nephritis, and vasculitis.

Main Results:

• Belimumab demonstrated efficacy in reducing SLE activity in patients resistant to conventional therapy (BLISS 52 study).
• Long-term data from the ALMS study indicated mycophenolate mofetil's superiority over azathioprine in maintaining remission for severe lupus nephritis.
• Rituximab was confirmed as a viable alternative to cyclophosphamide for controlling ANCA-associated vasculitis (RAVE and RITUXVASC studies).

Conclusions:

• Belimumab represents a significant advancement in treating difficult-to-manage SLE.
• Mycophenolate mofetil offers improved long-term remission maintenance for severe lupus nephritis compared to azathioprine.
• Rituximab provides an effective alternative treatment option for ANCA-associated vasculitis.