Roy Fleischmann, MD: Updates in Systemic Lupus Erythematosus

Rheumatology Network interviewed Roy Fleishmann, MD, to discuss his Rheumatology Winter Clinical Symposium presentation, “SLE Update: Novel treatments, and how we assess them.” Fleishmann is Clinical Professor of Medicine at the University of Texas Southwestern Medical Center at Dallas and co-Medical Director of the Metroplex Clinical Research Center in Dallas.

During his lecture, he will be discussing the new systemic lupus erythematosus (SLE) metric, called systemic lupus erythematosus disease activity state (SLE-DAS), which has cut offs for remission, mild, moderate, and severe disease activity. While it is a new metric that needs to be validated, it can be used in both the clinic as well as clinical trials and Fleischmann believes it may be a valuable tool. As in other rheumatic diseases, if low disease activity can be achieved, remission and damage prevention in patients affected by SLE is possible.

Additionally, he will be explaining biomarkers, an important factor in all rheumatic diseases, as it relates to lupus. Fleischmann states that while there aren’t very many good biomarkers across rheumatology, a few biomarkers specifically related to lupus may be of value. Found in urine, they are more easily obtained. He wonders whether the resolution of proteinuria itself in patients with lupus nephritis may fully correlate with the lack of progression and renal damage in this patient population. He delves into an abstract that shows that it’s not entirely true that patients can have a resolution of proteinuria yet still have a decrease in glomerular filtration rate.

Fleischmann takes a bit of time to touch on approved molecules, such as hydroxychloroquine, the baseline drug for lupus treatment. Interestingly, a recent abstract presented at the American College of Rheumatology (ACR) conference theorized that if a patient is in a state of low disease activity and hydroxychloroquine is either tapered or discontinued, the chances of flare are quite high.

To learn more, view the interview below: