Treat-to-Target is Feasible and Beneficial in Lupus
Treat-to-Target is Feasible and Beneficial in Lupus

September 19, 2019

Treating patients with lupus until they reach specific health goals can reduce disease flares and prevent organ damage, according to a research team co-led by Professor Eric F. Morand, at Monash University in Australia and past recipient of the Distinguished Innovator Award from the Lupus Research Alliance (LRA). This study is important because it provides specific standards that allow doctors to see how well lupus treatment is working and to predict the long-term prognosis for patients.

If patients have high blood pressure, doctors treat them with drugs until their blood pressure decreases to a certain level. This approach, known as treat-to-target, also works for other diseases such as rheumatoid arthritis and diabetes, but it’s been hard to use for lupus. The disease is so complex that doctors have been unsure what goal to aim for.

However, an international group of scientists that includes Professor Morand  has outlined five therapeutic goals that usually have positive long-term effects for patient: the lupus low disease activity state (LLDAS).  These targets include “no activity in major organ systems” and “prednisone use of less than 7.5mg a day.”

Professor Morand and colleagues tested if more than 1,700 patients could reach LLDAS targets and if meeting them was helpful. In a report published by the prestigious journal The Lancet Rheumatology, scientists reveal that 78% of the patients could reach LLDAS goals at least once. When they did, their symptoms improved. Patients who reached the LLDAS targets 50% of the time, for instance, had fewer disease flares and were less likely to have further damage to their kidneys or other organs.

“Developing better endpoints for measuring treatment response in lupus is essential to improve trial success rates and to guide clinical practice. We established this very large study with the goal of doing this, and the results confirm LLDAS as an endpoint which, when achieved in a sustained way, is profoundly protective,” said Professor Morand. “This study is particularly important for the design of clinical trials because it indicates that LLDAS provides a standardized way for researchers to find out whether a drug has a positive impact on the disease. We see LLDAS already being taken up as a measure in clinical trials, and we are hopeful it will be formally approved as an outcome measure by agencies such as the Food and Drug Administration. This is somewhere the LRA and patient groups could really help through their advocacy,” said Professor Morand.

Watch this video to hear directly from Dr. Morand about the work he’s doing with support from the Lupus Research Alliance.

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