Highlights of the American College of Rheumatology 2011 Annual Scientific Meeting
While research continues on new therapies for lupus, the 2011 American College of Rheumatology (ACR) was particularly notable for its insights into how to design such trials, according to ALR Scientific Advisory Board Chair Mary (Peggy) K. Crow, MD.
One of the most important and, yes, even exciting presentations came from David Wofsy, MD, professor of rheumatology at the University California-San Francisco, she said. Dr. Wofsy’s presentation, highlighted here, provided a “what if” perspective on the abatacept clinical trial for lupus nephritis, demonstrating that the trial would have had far better outcomes if its primary endpoints had been less restrictive. The exercise demonstrates the importance of choosing the most appropriate outcome measures for clinical trials in lupus, Dr. Crow said, and reiterates the learning curve that still exists in designing clinical trials for what is a very complex and heterogenous disease. “It’s a message to keep an open mind and understand that we still don’t know the best way to design the trials yet, but that we’re learning all the time,” she said.
She also found hope in the results of a large pregnancy study presented at the meeting by ALR grantees Jane Salmon, MD, of the Hospital for Special Surgery in New York, and Jill Buyon, MD, of New York University School of Medicine. The study showed that pregnancy in women with lupus was far safer than previously thought. “The message is that pregnancy is certainly an option for lupus patients,” Dr. Crow said. The study also demonstrated the growing importance of lupus registries of real-life patients in improving our understanding of the disease, its complications, and its progression.
On the basic science side, Dr. Crow highlighted the numerous studies focused on the role of the innate immune system—the part of the immune system designed to respond immediately to threats, versus the adaptive immune system, which takes longer to mount a response—in lupus. “The role of the innate immune system, which was not really recognized as being so significant in lupus pathogenesis not so long ago, continues to be stronger and stronger,” she said. Of particular interest, she said, is the role of neutrophils and immune system nucleic acid-containing complexes that activate the innate immune system, contributing to the production of pro-inflammatory chemicals such as interferon.
More advanced, however, is work on biomarkers in lupus. Dr. Crow highlighted a study she and her colleagues presented, which linked clinical features to gene and protein expression patterns. Once validated in additional studies, she said, it could eventually help clinicians predict the course of the disease and select therapies based on the molecular characteristics of the disease and the patient, just as we’re starting to do today in cancer.
Click here to download ALR’s special report from the meeting, or see above for links to the report.
Click here to see the 2010 ACR Special Report.
More information about lupus and treatment advances can be found by visiting www.lupusresearch.org.
The Alliance for Lupus Research Special Report on the 2011 American College of Rheumatology Meeting was made possible in part by generous support from Genentech.
The Alliance for Lupus Research is not affiliated with the American College of Rheumatology.
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