Optimising surveillance and treatment outcome in SLE

The overall purpose of this project is to optimise the use of current therapies in SLE and increase awareness regarding important non-pharmacological interventions, such as smoking cessation. 

In a previous study, we demonstrated that tobacco smoking was associated with a lower probability to respond to treatment with the anti-BAFF biological agent belimumab [1], especially in patients with mucocutaneous involvement [2]. In a forthcoming study within the frame of this project, we will explore whether the association between smoking and belimumab inefficacy depends, at least partly, on the development of anti-drug antibodies (ADA), as previously shown in studies of e.g. multiple sclerosis [3] and rheumatoid arthritis [4]. We will investigate the frequency and consequences of ADA against belimumab, including the potential connection between ADA development and belimumab inefficacy in smokers. That would provide a strong rationale for smoking cessation prior to belimumab initiation.


  1. Parodis I, Sjöwall C, Jönsen A, Ramsköld D, Zickert A, Frodlund M, Sohrabian A, Arnaud L, Rönnelid J, Malmström V, Bengtsson AA, Gunnarsson I. Smoking and pre-existing organ damage reduce the efficacy of belimumab in systemic lupus erythematosus. Autoimmunity Reviews. 2017; 16: 343–351


    Link: https://pubmed.ncbi.nlm.nih.gov/28216072/   


  1. Parodis I, Gomez A, Frodlund M, Jönsen A, Zickert A, Sjöwall C, Bengtsson AA, Gunnarsson I. Smoking reduces the efficacy of belimumab in mucocutaneous lupus. Expert Opinion on Biological Therapy. 2018; 27(9): 1470–1478


    Link: https://pubmed.ncbi.nlm.nih.gov/29958508/  


  1. Hedström AK, Alfredsson L, Lundkvist Ryner M, Fogdell-Hahn A, Hillert J, Olsson T. Smokers run increased risk of developing anti-natalizumab antibodies.Multiple Sclerosis Journal. 2014 Jul;20(8):1081-5


    Link: https://pubmed.ncbi.nlm.nih.gov/24311118/  


  1. Quistrebert J, Hässler S, Bachelet D, Mbogning C, Musters A, Tak PP, Wijbrandts CA, Herenius M, Bergstra SA, Akdemir G, Johannesson M, Combe B, Fautrel B, Chollet-Martin S, Gleizes A, Donnellan N, Deisenhammer F, Davidson J, Hincelin-Mery A, Dönnes P, Fogdell-Hahn A, De Vries N, Huizinga T,Abugessaisa I, Saevarsdottir S, Hacein-Bey-Abina S, Pallardy M, Broët P, Mariette X; ABIRISK Consortium. Incidence and risk factors for adalimumab and infliximab anti-drug antibodies in rheumatoid arthritis: A European retrospective multicohort analysis. Seminars in Arthritis and Rheumatism. 2019 Jun;48(6):967-975


    Link: https://pubmed.ncbi.nlm.nih.gov/30420245/