Update on cutaneous lupus

Dr Valerie Reynaert, dermatologist at UZ Brussels, with a main focus on auto-inflammatory and autoimmune diseases, shared key highlights on CLE from a dedicated session at EADV.

The session offered a rich overview of clinical cases, diagnostic considerations, and especially the rapidly evolving therapeutic landscape.

Recent progress in SLE has strongly influenced treatment perspectives for CLE. In Belgium, both anifrolumab and belimumab are now approved and reimbursed for SLE. Clinical experience has shown favorable effects on cutaneous manifestations, particularly with anifrolumab, which has subsequently led to phase III studies in CLE, including the LAVENDER trial. These results indicate that targeted biological therapy is becoming increasingly relevant for dermatological practice.

Beyond these established therapies, several new molecules are under investigation. Litifilimab, directed against plasmacytoid dendritic cells, is currently in phase III trials for both SLE and CLE. In addition, selective small-molecule inhibitors such as deucravacitinib and upadacitinib—already well known in dermatology for psoriasis and atopic dermatitis—have demonstrated encouraging efficacy in phase II studies of CLE, with phase III trials now underway. These advances suggest that broader classes of immunomodulatory agents may soon be available for patients with cutaneous disease.

Another emerging area of interest is CAR T-cell therapy, already established in haemato-oncology. This approach, which targets B cells or plasma cells, has the potential to redefine therapeutic strategies in severe autoimmune disease. Although safety and feasibility in CLE remain to be clarified, early discussions highlight its possible role in the long-term future of lupus management.