Current opinion in rheumatology
April 4, 2026 · via Europe PMC
Pathogenesis-directed lupus therapeutics.
Poudyal B, Perl A.
AI summary — for doctors, generated from the abstract only
This review surveys how insights into lupus pathogenesis are driving targeted antibody, cell-based, and T-cell engager therapies, while flagging infection risk and nonpharmacologic options.
What was studied
A narrative review of FDA-approved SLE therapies, ACR management guidance, emerging pathogenesis-directed biologics, and nonpharmacologic strategies such as dietary modification.
Key findings
- SLE management is guided by organ involvement and disease severity
- New therapies include engineered antibodies, CAR-based cell therapies, and T-cell engagers
- Emerging targets extend beyond B-cell and plasma cell markers to CD40L, endosomes, and mitochondria
- Infection remains a leading cause of morbidity and mortality with immunosuppressive biologics
Clinical relevance
The review offers an overview of a rapidly changing therapeutic landscape in SLE; it does not present new trial data and many emerging approaches remain investigational.
Who should care
Limitations
Narrative review without systematic methods; evidence quality for discussed therapies varies and is not graded in the abstract.
Lupus therapy is shifting toward mechanism-targeted treatments, with infection risk remaining a central concern.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Purpose of review
Systemic lupus erythematosus (SLE) is a complex autoimmune disease characterized, posing significant challenges to effective management. This review summarizes current United States Food and Drug Administration -approved therapies and management guidelines of the American College of Rheumatology.
Recent findings
Contemporary SLE management is guided by organ systems involvement and disease severity. Discoveries of molecular mechanisms underlying disease pathogenesis have driven the development of targeted biologic therapies, including natural and engineered antibodies, chimeric antigen receptor-guided cell therapies, and T-cell engagers, transforming the therapeutic landscape of lupus. In addition to traditional B-cell and plasma cell surface targets, emerging molecular targets include transmembrane signaling molecules such as CD40L and intracellular organelles such as endosomes and mitochondria.
Summary
While antibody and cell-based biologic therapies target pathogenesis-driving molecules, they suppress key immune pathways and thus infection remains a leading cause of morbidity and mortality. Accordingly, this review also addresses nonpharmacologic strategies - such as dietary modifications - that may confer therapeutic benefit without increasing susceptibility to infection. With a rapidly expanding portfolio of mechanistically driven clinical trials, the future of SLE management appears increasingly promising.
DOI
10.1097/bor.0000000000001160
PMID
41934146
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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