April 1, 2020

An investigational treatment, iguratimod showed positive results in an early clinical study of people with lupus nephritis that is refractory, meaning it has stubbornly resisted previous treatment with at least two immunosuppressants. Results were reported in Arthritis Research & Therapy.

The small study included 14 patients with refractory lupus nephritis. Each were given iguratimod instead of their previous immunosuppressant but kept on their regular dose of steroids.

Ninety-two percent of the patients responded to the treatment – either complete or partial remission as defined by specific lab measurements when their urine was tested. In lupus nephritis, the immune system causes damage to the kidneys which causes protein to leak into the urine. Measuring the amount of protein in the urine gives insight into how healthy (or not healthy) the kidneys are. Complete remission was defined as normal counts of protein, a compound called creatinine and blood cells in the urine. Partial remission was defined as at least a 50 percent decrease in protein levels, a specific level of blood cells and an increase of no more than 25 percent in creatinine. Complete remission was seen in 38.5 percent of the patients while 53.8 percent showed partial remission.

Scientists also monitored whether patients experienced flares, how long remission lasted as well as the safety of the drug.

Iguratimod is approved for treating rheumatoid arthritis, another autoimmune disease, in northeast Asia. This trial was based on an earlier study of mice with lupus where iguratimod prevented nephritis, lowered the amount of protein in the urine and reduced inflammation in the kidneys.

Study authors concluded: “Our findings suggest that the novel immunomodulatory drug iguratimod may be a new candidate for the treatment of LN. More studies are warranted to verify the efficacy of iguratimod in the treatment of LN as well as other manifestations of SLE.”