Jafari Alexander J, McGee Christina, Klimas Natasha, Hebert Adelaide A
Department of Dermatology, UTHealth McGovern Medical School, Houston, TX, USA.
UTHealth McGovern Medical School, Houston, TX, USA.
Clin Exp Dermatol. 2025 Jan 27;50(2):314-322. doi: 10.1093/ced/llae374.
Cutaneous lupus erythematosus (CLE) is a complex autoimmune disease often characterized by a multitude of skin findings. CLE is generally classified into three main categories: acute CLE, subacute CLE and chronic CLE. The current therapeutic guidelines for CLE include counselling patients on general measures and medication regimens. Treatment options include optimized photoprotection, avoidance of environmental triggers, corticosteroids, topical and systemic immunomodulators, and antimalarials. To date, no biologic medications (i.e. monoclonal antibodies, mAbs) are approved for CLE. The first mAb for the treatment of both systemic lupus erythematosus (SLE) and active lupus nephritis was belimumab, and was approved for these diseases in 2011 and 2020, respectively. Belimumab is a specific inhibitor of B-lymphocyte stimulator. Anifrolumab, a type I interferon receptor antagonist, was approved in 2021 for SLE. Other mAbs with different targets, including a novel biologic that inhibits blood dendritic cell antigen 2, are currently under investigation for CLE. This review will describe the general treatment landscape for CLE. Selected studies related to these various mAbs will be discussed, as well as their safety profiles and efficacies demonstrated in clinical trials. Biologic medications can potentially augment the number of treatment options for patients living with CLE.
皮肤红斑狼疮（CLE）是一种复杂的自身免疫性疾病，通常表现为多种皮肤症状。CLE一般分为三大类：急性CLE、亚急性CLE和慢性CLE。目前CLE的治疗指南包括就一般措施和药物治疗方案对患者进行咨询。治疗选择包括优化光防护、避免环境诱因、使用皮质类固醇、局部和全身免疫调节剂以及抗疟药。迄今为止，尚无生物药物（即单克隆抗体，mAbs）被批准用于CLE。第一种用于治疗系统性红斑狼疮（SLE）和活动性狼疮性肾炎的单克隆抗体是贝利尤单抗，分别于2011年和2020年被批准用于这些疾病。贝利尤单抗是B淋巴细胞刺激因子的特异性抑制剂。阿尼鲁单抗是一种I型干扰素受体拮抗剂，于2021年被批准用于SLE。其他具有不同靶点的单克隆抗体，包括一种抑制血液树突状细胞抗原2的新型生物制剂，目前正在针对CLE进行研究。本综述将描述CLE的总体治疗情况。将讨论与这些各种单克隆抗体相关的选定研究，以及它们在临床试验中显示的安全性和疗效。生物药物可能会增加CLE患者的治疗选择数量。
