New York, NY. September 25 — The Lupus Research Alliance presented its 2020 Lupus Insight Prize to Jane Salmon, MD for her work in improving the health of pregnant women with lupus and antiphospholipid syndrome. The prize was formally “presented” to Dr. Salmon by LRA Scientific Advisory Board Chair Gary Koretzky, MD during a virtual award ceremony today during the Lupus2020@Home program of the Lupus 21st Century meeting.
The LRA recognized Dr. Salmon’s discoveries of the causes of pregnancy complications and miscarriage in patients with lupus and in another autoimmune disease, antiphospholipid syndrome (APS), that may occur in patients with lupus and is often associated with poor pregnancy outcomes.
The prize will allow Dr. Salmon to develop a tool to identify patients with high-risk pregnancies and conduct a trial to determine whether certolizumab, a drug used for rheumatoid arthritis, will reduce pregnancy complications in lupus patients with APS. Dr. Salmon is the Collette Kean Research Professor at Hospital for Special Surgery and Professor of Medicine and Professor of Medicine in Obstetrics and Gynecology and Associate Dean for Faculty Affairs at Weill Cornell College of Medicine.
The $100,000 Lupus Insight Prize recognizes a major, novel insight and/or discovery that holds the promise of advancing the understanding of lupus and has a high likelihood of improving the diagnosis and treatment of the disease.
Over the past 15 years Dr. Salmon has focused on lupus and APS and how they cause complications during pregnancy. In her early work, Dr. Salmon identified immune molecules, known as the complement, as drivers of pregnancy complications caused by APS. In mouse models of APS, the complement system is turned on by autoantibodies on the surface of the developing placenta. This activation unleashes inflammation that harms the placenta and can lead to pregnancy loss and/or impaired fetal growth and development. In a recent study of pregnant women, Dr. Salmon showed that complement activation is a strong predictor for adverse pregnancy outcomes in patients with lupus and/or APS.
“Forty-four percent of pregnant women with APS experience pregnancy complications, including preterm delivery and miscarriage, due to inflammation in the placenta. Therapies that reduce placental inflammation appear to be a promising treatment for patients with APS and lupus at high risk for pregnancy complications,” said Dr. Salmon.
In addition to her work on complement, Dr. Salmon has studied the role of tumor necrosis factor (TNF), a potent inflammatory molecule that causes joint destruction in rheumatoid arthritis and kidney damage in lupus. Dr. Salmon and her team found that treatment with drugs that block the action of TNF can protect pregnant mice with APS and their fetuses from harm. This work suggested that release of TNF contributes to pregnancy loss in women with APS and lupus and served as the basis for a clinical trial (IMPACT study) to test certolizumab, a TNF blocking drug, in high risk pregnancies in women with APS and/or lupus. The Insight Prize will allow Dr. Salmon and her colleagues to extend the IMPACT trial and determine whether and how certolizumab improves pregnancy outcomes.
In the second part of her project, Dr. Salmon and her colleagues will to develop a tool to risk stratify lupus pregnancies, that is, to determine the likelihood that a pregnancy will be uncomplicated or will lead to preeclampsia or other serious problems for the mother or fetus. She and her team will first apply powerful computer technologies to data from the PROMISSE study, a multicenter clinical study she led that followed over 500 pregnant patients with lupus and/or APS. They hope to identify patterns of clinical features and biomarkers present at the very beginning of pregnancy that predict increased risk for complications. She will then test her prediction algorithm with extensive data from 1,000 lupus pregnancies followed by collaborators from Europe and North America. Once validated in this diverse patient population, her team will develop an online tool to assist physicians and patients in clinical decision making and counseling lupus patients.
“Using this tool, doctors will identify women with lupus whose pregnancies are high-risk and require increased monitoring and, when indicated, additional treatment to protect the health of mother and fetus,” said Dr. Salmon. “And, they can reassure women who are at low risk for complications.”
“Dr. Salmon has found critical links between lupus and antiphospholipid syndrome with pregnancy complications and fetal loss” said Kenneth M. Farber, President and CEO, Lupus Research Alliance. “We are excited to fund her new work which has enormous potential to prevent pregnancy complications, such as preeclampsia, placental insufficiency, and fetal loss, using certolizumab, an FDA approved drug commonly used to treat rheumatoid arthritis.”
Lupus is a chronic, complex autoimmune disease that affects millions of people worldwide. More than 90% of people with lupus are women; lupus most often strikes during the childbearing years of 15-45. African Americans, Latin Americans, Asians and Native Americans are at two to three times greater risk than Caucasians. In lupus, the immune system, which is designed to protect against infection, creates antibodies that can attack any part of the body including the kidneys, brain, heart, lungs, blood, skin, and joints.
About the Lupus Research Alliance
The Lupus Research Alliance aims to transform treatment while advancing toward a cure by funding the most innovative lupus research in the world. The organization’s stringent peer review grant process fosters diverse scientific talent who are driving discovery toward better diagnostics, improved treatments and ultimately a cure for lupus. Because the Lupus Research Alliance’s Board of Directors fund all administrative and fundraising costs, 100% of all donations goes to support lupus research programs.