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Lenalidomide treatment of cutaneous lupus erythematosus: the Mayo Clinic experience
Author(s) -
Kindle Scott A.,
Wetter David A.,
Davis Mark D. P.,
Pittelkow Mark R.,
Sciallis Gabriel F.
Publication year - 2016
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/ijd.13226
Subject(s) - medicine , lenalidomide , dermatology , lupus erythematosus , cutaneous lupus erythematosus , systemic lupus erythematosus , medline , disease , immunology , multiple myeloma , antibody , political science , law
Background Published case series describe lenalidomide as an effective treatment of refractory cutaneous lupus erythematosus ( CLE ). Objectives The present study aimed to further characterize lenalidomide use in the treatment of CLE . Methods A retrospective review of patients treated with lenalidomide for CLE from January 1, 2000, to December 17, 2014, was conducted. Results Eight of the nine patients (89%) were women. Their median age at initiation of lenalidomide was 62 years (range: 41–86 years). Subtypes of CLE included discoid lupus erythematosus ( DLE ) ( n = 6), lupus panniculitis ( n = 2), and subacute CLE ( n = 1). Before the initiation of lenalidomide, all patients had been previously treated unsuccessfully or were intolerant to at least one antimalarial and one immunosuppressive agent. With lenalidomide, five patients achieved a complete response ( CR ), two a partial response, and two had no response (lupus panniculitis). Time to initial response (dose range: 2.5–10.0 mg/d) varied from 2 weeks to 3 months; the median time to CR in five patients was 3 months (range: 3–6 months). The median duration of lenalidomide therapy was 12 months (range: 2–67 months). The median duration of follow‐up was 48 months (range: 20–103 months). Adverse effects included mild leukopenia; one patient had deep vein thrombosis of unclear etiology during a hospitalization. No patients developed or showed progression of systemic LE while receiving lenalidomide. Conclusions Lenalidomide was effective for the treatment of CLE (particularly DLE ) but not for the treatment of lupus panniculitis in this series.