Lenalidomide treatment of cutaneous lupus erythematosus: the Mayo Clinic experience. (12th February 2016)

• Record Type: Journal Article
• Authors: Kindle, Scott A.; Wetter, David A.; Davis, Mark D. P.; Pittelkow, Mark R.; Sciallis, Gabriel F.
• Is Part Of: International journal of dermatology. Volume 55:Number 8(2016)
• Page Start: e431
• Page End: e439
• Publication Date: 2016-02-12
• Subjects: Dermatology -- Periodicals; 616.5
• DOI: 10.1111/ijd.13226
• Languages: English
• ISSNs: 0011-9059

Abstract

Abstract: 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.