eprintid: 10159391 rev_number: 11 eprint_status: archive userid: 699 dir: disk0/10/15/93/91 datestamp: 2022-11-16 11:55:38 lastmod: 2023-10-30 11:06:04 status_changed: 2022-11-16 11:55:38 type: article metadata_visibility: show sword_depositor: 699 creators_name: Lorenzo-Vizcaya, Ana creators_name: Isenberg, David Alan title: Clinical trials in systemic lupus erythematosus: the dilemma—Why have phase III trials failed to confirm the promising results of phase II trials? ispublished: pub divisions: UCL divisions: B02 divisions: C10 divisions: D17 note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. abstract: Systemic lupus erythematosus (SLE) is an autoimmune rheumatic disease of unknown aetiology, characterised by the production of auto-antibodies and formation of immune complexes against self-antigens and complement activation. This inflammatory response can lead to tissue infiltration and eventually, to organ damage.Patients with SLE invariably have periods of relapse and remission. Flares can occur even when the patient is on seemingly adequate treatment, which suggests that more effective therapies are necessary for the management of SLE. Thus, trials with many drugs against different targets, such as CD22, IL-12 and IL-23 or tyrosine kinases, have been carried out in recent years.A frustrating feature of some of the biologic drugs used to treat SLE has been the reporting of successful phase II trials followed by failures of the phase III trials.In this review, we will focus on phase II and III trials carried out with epratuzumab (anti CD22), baricitinib (Janus kinases inhibitor), rigerimod (P140 peptide) and ustekinumab (IL-12 and IL-23 inhibitor) and consider the reasons for their ultimate failure to 'make the grade'. Likewise, we will try to explain the possible reasons that can influence why good results may be obtained in phase II trials and lead to undue optimism. date: 2023-02 date_type: published publisher: BMJ PUBLISHING GROUP official_url: https://doi.org/10.1136/ard-2022-222839 oa_status: green full_text_type: other language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1981491 doi: 10.1136/ard-2022-222839 medium: Print-Electronic pii: ard-2022-222839 lyricists_name: Isenberg, David lyricists_id: DAISE40 actors_name: Isenberg, David actors_name: Geary, Esther actors_id: DAISE40 actors_id: ECGEA88 actors_role: owner actors_role: impersonator full_text_status: public publication: Annals of the Rheumatic Diseases volume: 82 number: 2 pagerange: 169-174 pages: 6 event_location: England issn: 0003-4967 citation: Lorenzo-Vizcaya, Ana; Isenberg, David Alan; (2023) Clinical trials in systemic lupus erythematosus: the dilemma—Why have phase III trials failed to confirm the promising results of phase II trials? Annals of the Rheumatic Diseases , 82 (2) pp. 169-174. 10.1136/ard-2022-222839 <https://doi.org/10.1136/ard-2022-222839>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10159391/2/Isenberg_CLINICAL%20TRIALS%20IN%20SYSTEMIC%20LUPUS%20ERYTHEMATOSUS%20CLEAN%20COPY%2021.07.2022.pdf