Milena Tocut, Israel
Edith Wolfson Medical Center Internal Medicine CPresenter of 2 Presentations
SYSTEMIC LUPUS ERYTHEMATOSUS: AN EXPERT INSIGHT INTO EMERGING THERAPY AGENTS IN PRECLINICAL AND EARLY CLINICAL DEVELOPMENT
Abstract
Background and Aims
Systemic lupus erythematosus (SLE) is a chronic disease that may be fatal. In the era of revolutionary emerging novel biologic agents, an attempt of targeted therapy for these patients is mandatory. Novel therapies under investigation in phase II-III clinical trials showed promising results and potential. Therapies target different pathways involved in SLE including cytokines, signal transduction inhibitors, B cell depletion, interference with co-stimulation and others. Of interest is the proof of concept of sequential therapy. To date, it is still difficult to crack the puzzle in SLE therapy; therefore a new strategy may encompass targeting more than one protein.
Methods
In this article, we performed an extensive literature search via PubMed, Medline, Elsevier Science and Springer Link databases between the years 2014-2020 using the following terms: SLE, novel treatments. We have reviewed 232 articles and chosen the articles which focused on phase II-III emerging therapies and new findings on existing therapies attempting to reveal new breakthrough concepts in SLE treatment.
Results
It is time to change the approach from trials using lupus scores and proceed to blood tests that determine the subtype of lupus by the individual pathways which are activated. The key findings of our article are the substantial intensive ongoing research for new biologic therapy for SLE.
Conclusions
SLE therapy remains an enigma and a true challenge for drug development. Hopefully the future will enable ckinical bioengeneering technology which will lead to new SLE patints classifications. A breakthrough with interferon pathway related therapy is the most promising.
OUTCOMES OF ICU PATIENTS TREATED WITH IVIG FOR SEPSIS ANDOR AUTOIMMUNITY DISEASES
Abstract
Background and Aims
Background: Intravenous immunoglobulin (IVIG) is a biologic agents with a good safety and beneficial profile for a variety of diseases. IVIG, as an off-label agent, has consistently been advantageous for many different organ- specific or systemic autoimmune diseases. IVIG therapy may play a role as an add-on therapy for critically ill patients with autoimmune diseases requiring hospitalization in an intensive care unit (ICU)
Aims: To evaluate the outcomes of patients with SLE and other autoimmune diseases treated with IVIG in a single center ICU.
Methods
Methods: We conducted a retrospective study involving adult patients with autoimmune diseases who received IVIg in the ICU at Sheba Medical Center (2007-2019). We investigated many parameters: demographics, comorbidities, chronic medication use including steroids and immunosuppressive therapy, laboratory blood tests, need for vasopressors and/or mechanical ventilation upon admission to the ICU; indication for IVIG administration; IVIG protocol (including dose and duration); disease severity scores (Charlson Comorbidity Index; Sequential Organ Failure Assessment-SOFA score, SLEDAI, and outcomes including duration of hospitalization and mortality rates. We received approval from the research ethics committee of the participating medical center. Simple descriptive statistics, including means, medians, standard deviations and interquartile ranges, were used. P<0·05 was considered significant.
Results
Results: Seventy patients treated with IVIG were identified. Parameters were evaluated by digital informatics (Metavision) and processed in an EXCEL chart.
Conclusions
Conclusions: IVIG may be a beneficial therapy for patients with autoimmune diseases who are severely ill requiring hospitalization in the ICU.