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Kenneth C. Kalunian

Researcher

Sep 30, 2026

1:26
And so one question I have is, why are targeted therapies needed to address unmet needs in cutaneous lupus or SLE with cutaneous manifestations?
1:37
Yeah, I think that this is really important for many reasons.
1:40
As a result, we actually are looking at patients who are in the dermatology realm but also have other manifestations of disease and others who are seen by rheumatologists who don't necessarily have the clarity and expertise of cutaneous manifestations of disease in terms of characterizing whether patients have chronic disease or more acute manifestations of disease.
2:08
Given that, I mean, I think when you have a patient who primarily has a need for treatment of CLE, it's important to know what drugs primarily hit that and hit that target very well.
2:23
And I think that when you have a patient who has a combination of manifestations of disease, you may want to use something different that has a broader scope.
2:34
So it's important to have data, at least, on patients responding to their needs for CLE manifestations as well as other manifestations of disease in combination with CLE.
5:35
And I think this will be very important also to see these data.
5:39
Very simply, I think that it's a step up, definitely, in terms of efficacy.
1:37
And that risk is particularly front-loaded within the first year after diagnosis, as the risk of myocardial infarction can be as high as six-fold.
1:46
And I think that's a critical point because historically our focus has been on controlling inflammation and preserving renal function.
1:52
But what this consensus and recent updates from the American College of Rheumatology are emphasizing is that we need to simultaneously think about continuous cardiovascular protection.
2:03
This is a paradigm shift away from just treating the flare to managing cumulative risk over time.
4:46
Now, going back to risk stratification, how are you practically incorporating these lupus-specific enhancers into your clinic? Because we don't yet have a universally adopted modified risk calculator.
4:57
That's the challenge.
4:59
What I've started doing is using standard tools like ACC risk estimation as a baseline, but then applying a qualitative adjustment.
5:08
For example, if a patient has active disease, is on chronic steroids, and has reduced EGFR, I essentially treat them as if they're in a higher risk category, often prompting earlier statin initiation or tighter blood pressure control.

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