Lupus & antiphospholipid syndrome
Patient selection for advanced B-cell-targeted therapy trials in systemic lupus erythematosus
Authors' conclusion
In a tertiary SLE cohort, referral for advanced B-cell-targeted therapies was associated with markers of high disease activity and renal involvement. However, multiple clinical and patient-related factors limited trial participation. These findings highlight important considerations in referral and trial participation for advanced B-cell-targeted therapies.
Study context
- Population
- Patients with systemic lupus erythematosus (SLE) treated with biologic therapies at a tertiary lupus service between January 2024 and December 2025, during active recruitment to ABT clinical trialspatients treated with biologics
- Participants
- 101 patients
- Exposure
- Patients discussed at ABT-MDT with those not referred within the same cohort
- ABT-MDTn = 21
- Outcome
- Discussed at ABT-MDT
Methodological detailsmultivariable analysis
- Multivariable analysis
Main finding
As reported in the abstract
Discussed at ABT-MDT
21
20.8%
Observational data: associations, not effects.
Further findings
Lupus nephritis · higher with ABT-MDT
P < 0.001
Daily prednisolone dose · higher with ABT-MDT
P < 0.001
| Outcome | ABT-MDT | NOT REFERRED | P value |
|---|---|---|---|
| SLEDAI-2K scoresHigher with ABT-MDT | 16.0 | 2.0 | P < 0.001 |
Exposure to prior immunosuppressive therapies
- Greater exposure to prior immunosuppressive therapies in patients referred for ABT-MDT
ABT-MDT referral (multivariable analysis)
- Higher SLEDAI-2K, OR 1.92 per 4-point increase
- 1.92 (95% CI 1.10-4.27)
- Prednisolone dose, OR 3.44 per 5-mg increase
- 3.44 (95% CI 1.23-14.50)
- Independently associated with ABT-MDT referral
Proceeded to ABT
- Of those discussed, patients proceeded to ABT
- 7
Reasons for non-participation
- Patient preference, perceived infection risk, clinical improvement, and protocol-related constraints
Original publication
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