Autoimmune diseases are gaining attention

Rheumatoid arthritis (RA), multiple sclerosis, Type 1 diabetes, and lupus have one major factor in common. They are all autoimmune diseases, so named because the immune system mistakenly recognizes the body's own proteins as foreign invaders and begins producing antibodies that attack healthy cells and tissues.

"There's some evidence to suggest that female hormones as opposed to male hormones are more immunoactive, so they stimulate B-cell activity and promote immune response," said Susan Manzi, M.D., MPH, associate professor, University of Pittsburgh School of Medicine.

First identified in the 13th century, lupus is a Latin term for "wolf," because a rash that often appears on the face of a lupus patient can resemble a wolf's appearance. Lupus is an incurable, sometimes fatal disease of the immune system that affects about 1.5 million Americans, according to LFA. The symptoms of lupus, such as extreme fatigue, achy joints, skin rashes, and anemia, can resemble those of other autoimmune diseases such as RA. Lupus almost always strikes young adults, and nine out of 10 people with lupus are women. It's also two to three times more common in African-Americans and Asians than in Caucasians.

Burgeoning pipeline

While lupus is not a rare disease, some observers believe that it has been overlooked for many years. In fact, there has not been a new medication specifically approved for lupus in the past four decades. The good news is that that is expected to change. According to experts, there will be, at a minimum, several new medications to treat lupus and its symptoms in the next few years.

"Considering how many potential therapeutic agents are in the pipeline or currently being tested-even if you subscribe to a small percentage of those actually proven to be effective or approved by the Food & Drug Administration for use in lupus-we are still going to have several new therapies available," said Manzi, codirector of the lupus center at the University of Pittsburgh. "Even in the worst possible scenario," she added, "we are going to be way ahead of where we have been for years."

New studies are looking at genes that play a role in lupus and the immune system, ways to alter the immune system, the role of hormones, and certainly new treatments for the disease. "In the past 20 years we have learned a lot more about the immune system that will further help drug development in this area," said Merrill. While a number of investigational drugs are in clinical trials, only a few are in the late stages of clinical development.

Biologics coming

There are several promising novel compounds being tested, including hormone modifiers and more selective immunosuppressive drugs, but it's the biologic agents that are capturing the spotlight. Researchers are harnessing the power of the body's own immune system to help fight disease through recombinant DNA technology. DNA molecule-based treatments selectively block pathways of the immune system from forming autoantibodies that are involved in the inflammation and damage that occur with lupus and halt tissue destruction.