Subacute cutaneous lupus erythematosus

We do that, again, because we're assessing the immunologic activity of the disease as a whole, not just the skin.

I think I'd love to hear from Joe and Vicki, in patients with primary discoid or SCLE, not with SLE, maybe it's different.

Right.

I mean, I'll just, again, remind folks, I think... you know, taking the rheumatology hat off, putting the derm hat on for a moment, you all know, you know, in particular localized discoid, this comes down again to some of the subsets, localized discoid lupus patients, there's a, you know, large number of these patients who are even ANA negative, who are, you know, have no serologic positivity, You know, there's some cross-sectional estimates that vary depending on whether it's more generalized lesions, whether they're more localized.

So, yeah.

So I asked the audience, in your practice, upper left here, the most problematic form of CLE is what? And their number one answer was, it was kind of a mix here, but it was mainly DLE, 37%, followed by the other usually hard to spell forms of CLE, lupus tumidus, profundus, paniculitis, and whatnot.

Because we usually, when we get that back on a biopsy or from a term report, we're like, what the hell? And what am I doing about this? And And then SCLE, those are the dominant things.

I was surprised that they, you know, acute LE, malar rash, mucosal lupus, and alopecia lupus are relatively minor concerns of the majority of the audience.

I'm a professor of dermatology and rheumatology at the University of Pennsylvania.

I'm going to be talking about an abstract that was presented at the EADV in Vienna related to the efficacy and safety of litophilumab in cutaneous lupus.

It was a 52-week result of a Phase II study.

And so, basically, we have no approved drugs for cutaneous lupus in the past 80 years, and And this particular agent has now been studied in, this is the second phase two trial, and this is looking at the time between the initial randomized trial and week 52.

And so essentially the patients that were enrolled in this trial It had either discoid lupus or SCLE, with or without systemic disease, but not severe systemic disease.

And the agent that was used is a drug called Letofilamab, which is a drug that is an antibody against BDCA2.

So there's been some early studies that showed that after one injection a month later, just that there were a decrease in type 1 interferon of regulated proteins in the skin that were associated with a decrease in disease activities measured by the CLASI activity score.

And in the study that was presented, patients got either placebo or lidophilumab.