Apremilast is in development as an oral treatment for oral ulcers in people with active Behçet’s disease. Behçet’s disease (or Behçet’s syndrome) is a rare and poorly understood condition that results in inflammation of the blood vessels and tissues. The condition is characterised by flare-ups (relapses) followed by periods where the symptoms disappear (remission). The cause of Behçet’s disease is thought to be an interaction between genetics and environmental factors. As Behçet’s disease affects multiple systems it has various symptoms such as mouth or genital ulcers, painful eyes and blurred vision, acne-like spots and painful joints. The most commonly reported symptoms are oral and genital ulcers.
Apremilast works by suppressing the activity of inflammatory pathway caused by molecules such as interleukins and tumour necrosis factors. In turn this reduces inflammation. Currently, specific curative treatment options for Behçet’s disease are very limited and treatment relies on controlling symptoms and relieving pain. Apremilast has shown promise in targeting oral ulcers in patients with Behçet’s disease, and if licensed it could be an effective treatment option for this patient group.
Belimumab is in clinical development for the treatment of adults with active lupus nephritis (LN) who are uncontrolled on current standard of care. LN is a complication affecting kidney function brought on by systemic lupus erythematosus (SLE), a chronic autoimmune, inflammatory disease that affects different organs. Around a third of people suffering with SLE will develop LN. The kidney damage seen in LN occurs due to a person’s immune cells (B Cells) attacking their own kidneys which causes inflammation and affects overall kidney function. Current treatment involves suppression of the immune system and management of symptoms, but it is not always effective. If left untreated, LN can lead to kidney failure which requires dialysis or a kidney transplant.