Possible new option for CNS lupus, lupus nephritis, and lupus polyarthritis

Came across this information yesterday and thought it was interesting. Perhaps someone on this site may find it helpful. I have pasted the blog I posted, in its entirety, below:

IL-6, Lupus and Tolicizumab

Taming the Cytokine Storm

Most of us who have lupus know that its destructive inflammation comes from an immune system in hyper-drive. The symptoms of an acute and devastating lupus flare can resemble the symptoms of an acute attack of flu. Cytokines, critical actors in the immune response, play a role in both the lupus and flu responses. Doctors have a term for the dramatic release of cytokines during these events: cytokine storm. One cytokine, IL-6 (interleukin 6 ) has been implicated in acute lupus inflammation; this is particularly true in CNS lupus (see: onlinelibrary.wiley.com/doi... and in patients with active proliferating lupus nephritis (see: hindawi.com/journals/ijr/20...

The good news is that tolicizumab, a drug used successfully in rheumatoid arthritis, has proven effective at limiting IL-6 activity in some manifestations of SLE. Clinical trials showed that a significant percent of study participants not only had a reduction in serum markers for lupus activity, but also experienced a reduction in symptoms. While there were side effects noted, one research article judged these to be "acceptable in a clinical setting" (see hindawi journal cited in the above paragraph).

In addition to targeting CNS lupus and lupus nephritis, Tocilizumab is being considered as a possible therapy for SLE patients who have arthritis. An article on the National Institutes of Health website describes a patient who had a variety of symptoms, including "polyarthritis". The 22-year old female patient was not responding well to a number of therapies and had failed at several attempts to lower steroid use (to under 10mg a day). When it was noted that the patient had elevated levels of IL-6, Tocilizumab was administered. It worked. The patient experienced a remission of symptoms and was finally able to taper steroid use.(http://www.ncbi.nlm.nih.gov/pubmed/22334272)

While Tocilizumab is today an accepted therapy for RA, it continues to be evaluated as a treatment for SLE. Still, this drug holds promise as one approach to dealing with certain kinds of lupus. Its history with RA is encouraging. In some RA patients, tocilizumab was so effective that the patients eventually were symptom-free and able to stay that way without any kind of drug therapy. Let's hope tocilizumab offers the same relief to at least a subset of lupus patients.

3 Replies

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  • Hi Lupuswriter. Can you explain what CNS Lupus is?

    I had Lupus Nephritis many years ago and i wondered if CNS is linked to Lupus Nephritis.

    Be interested in your reply. Thank you.

  • Hi caz59,

    I'll try. Basically, if the central nervous system in involved, then it's CNS lupus. This can have a variety of symptoms. As far as treatment with tocilizumab is concerned, doctors found IL-6 in cerebrospinal fluid so they guessed this medicine would work. Tocilizumab seems to be targeted to suppress IL-6. I hope that helps--and that lupus nephritis stays out of your life forever!

    Sincerely, A. Moore (lupuswriter)

  • Brilliant news, thank you for sharing, I'm always looking out for upcoming medication for lupus, particularly for CNS lupus which is my biggest fear. My rheumatologist is specialising in RA so I will ask him about this next time I see him.

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