a Department of Internal Medicine B , Meir Medical Center , Kfar Saba , Israel.
b Division of Dermatology , Toronto Western Hospital , Toronto , Canada.
Expert Opin Biol Ther. 2018 Oct;18(10):1041-1047. doi: 10.1080/14712598.2018.1513484. Epub 2018 Sep 5.
Cutaneous lupus erythematosus (CLE) encompasses a spectrum of dermatologic manifestations which can occur with or without systemic lupus erythematosus (SLE). Treatment of CLE is challenging as the traditional treatments are off label and often fail and there is no drug specifically approved for CLE. The knowledge gained from the emerging trials on biologic therapy in SLE has provided insight into the utility of biologic therapy for CLE.
An overview is provided on the biological agents studied for CLE discussing their immunological target, their efficacy in treating the various CLE manifestations and the outcome measures used.
There is a paucity of trials dedicated to the biologic treatment of CLE. Several of the described biological treatments' efficacy suggests that different clinical phenotypes of CLE may require different immunological targeted therapies. Recently published and ongoing trials of SLE focusing on novel agents for CLE using the Cutaneous Lupus Area and Severity Index (CLASI) as the outcome measure have shown promising results. Further trials designed specifically to study the efficacy of biologic treatment in CLE subgroups with or without systemic involvement using specific metrics for assessing cutaneous involvement are needed and will aid in illuminating the role of biologic therapy in CLE.
皮肤红斑狼疮（CLE）包含一系列皮肤科表现，可伴有或不伴有系统性红斑狼疮（SLE）。由于传统治疗方法是超适应证使用，且往往无效，并且没有专门批准用于 CLE 的药物，因此 CLE 的治疗具有挑战性。从 SLE 生物治疗的新兴试验中获得的知识为生物治疗 CLE 的应用提供了深入了解。
本文概述了用于 CLE 的生物制剂的研究，讨论了它们的免疫靶点、治疗各种 CLE 表现的疗效以及使用的结局指标。
专门用于 CLE 生物治疗的试验很少。描述的几种生物治疗的疗效表明，不同的 CLE 临床表型可能需要不同的免疫靶向治疗。最近发表的和正在进行的 SLE 试验使用皮肤狼疮面积和严重程度指数（CLASI）作为结局指标，针对用于 CLE 的新型药物进行了研究，结果显示出有希望的结果。需要设计专门针对有或无系统受累的 CLE 亚组的生物治疗疗效进行研究的进一步试验，并使用评估皮肤受累的特定指标，这将有助于阐明生物治疗在 CLE 中的作用。
