Case report: Severe systemic lupus no longer detectable after cancer medication treatment

Medical Xpress / Charité - Universitätsmedizin Berlin / New England Journal of Medicine ^ | Sept. 5, 2024 | Tobias Alexander et al

[ConservativeMind]

Universitätsmedizin Berlin is astounded by the huge improvement seen in a female patient with severe systemic lupus erythematosus (SLE) after being treated with the cancer medication teclistamab.

Nearly six months after starting treatment, the patient is now completely symptom-free.

Nothing was sufficiently alleviating the symptoms of the 23-year-old patient from Berlin, including cortisone and eight other therapies that should have moderated her overactive immune system.

Her autoimmune disease, diagnosed as systemic lupus erythematosus, was particularly severe and was attacking four of her organ systems. Her skin was blistered, her joints and kidneys were severely inflamed, and her number of red blood cells, which supply oxygen to the body's tissues, was too low.

Because the established treatment pathways had all been exhausted, he suggested that the patient should take teclistamab—the first time this had been tried. Teclistamab is a bispecific antibody that is approved for the treatment of multiple myeloma.

In systemic lupus erythematosus, plasma cells produce autoantibodies, which are antibodies that target the body's own tissue.

Alexander, a consultant rheumatologist, explains, "Teclistamab is highly effective at destroying the plasma cells and also works against their progenitor cells, which would otherwise quickly produce new plasma cells."

With the patient's consent, the drug was prescribed "off-label." The therapy was delivered on an inpatient basis and proved successful: Five injections of the cancer medication administered under the abdominal skin over a period of five weeks gradually relieved the patient's symptoms.

Within a few weeks, her kidney function and blood levels improved and her skin and joint inflammation completely subsided. Since mid-April, no more autoantibodies have been detected in the 23-year-old's blood, even though the treatment with immunosuppressants was stopped before the start of the therapy and cortisone was no longer administered after six weeks.

"The patient is in full remission," says Alexander.

[ConservativeMind]

This is an available treatment, but was used off-label.

The patient has no lupus symptoms. There were some more serious side effects during treatment, but these went away when treatment stopped.

[ConservativeMind]

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[SisterK]

the test will be time
lupus can go dormant but does not necessarily go away

[telescope115]

Interesting. The side effects are worrisome, however.

[Pontiac]

Later

[TChad]

Thanks for the good news.