Table 4.
Bortezomib use in systemic autoimmune diseases.
| Study type | Autoimmune disease | Study population | N | Comments | References |
|---|---|---|---|---|---|
| Case report | SLE and MM | Adult (63 years) | 1 | • Bortezomib 1.5 mg/sqm on days 1, 4, 8 and 11 + steroids (28-day cycles) for three cycles • Response: clinical improvement • No toxicity |
Fröhlich et al. 49 |
| Case report | SLE and APS in IgA MM | Adult (70 years) | 1 | • Bortezomib 1.3 mg/sqm IV on days 1, 8, 15 and 22 (for four cycles) + dexamethasone • Response: PR of MM and disappearance of SLE autoantibodies, then MM progression after 3 years • Toxicity: G1 peripheral neuropathy |
Quartuccio et al. 50 |
| Case series | Refractory SLE | – | 20 | • Bortezomib 1.3 mg/sqm IV in 21-day cycles + dexamethasone (N = 16) for a median of two cycles (range: 1–4) • Response: clinical improvement (N = 20) • Toxicity: G3-4 infections (N = 3), fever (N = 2), G1-2 nausea (N = 3), headache (N = 3), polyneuropathy (N = 2), allergic skin reactions (N = 2) |
Alexander et al. 51 |
| Case series | SLE | – | 8 | • Bortezomib 1.3 mg/sqm for four injections in two cycles • Response: gradual and significant depletion of short- and long-lived PCs in peripheral blood and BM by 50%, accompanied by a significant reduction of autoantibodies and total Ig |
Alexander et al. 10 |
| Case series | Refractory lupus nephritis | Adult (median age 27.8 years, range: 21–43) | 5 | • Bortezomib 1.3 mg/sqm IV on days 1, 4, 8 and 11 of 21-day cycles for four cycles + steroids • Response: CR (N = 3), PR (N = 1), NR (N = 1) • Toxicity: G1-2 thrombocytopenia (N = 5), gastrointestinal (N = 3), neurotoxicity (N = 3), transient elevated creatinine (N = 2), fever (N = 3), zoster (N = 1), hypertension (N = 1) |
Zhang et al. 52 |
| Case series | Resistant lupus nephritis | – | 12 | • Bortezomib for a median of six (range: 5–7) weekly cycles • Response: CR (N = 1), PR (N = 10), NR (N = 1) • Toxicity: G2 polyneuropathy (N = 2) |
Segarra et al. 53 |
| Case report | Refractory primary Sjögren syndrome | Adult (44 years) | 1 | • Bortezomib 1.3 mg/sqm on days 1, 4, 8, 11, 22, 29, 36, 43, 50 and 57 • Response: clinical improvement • No toxicity |
Jakez-Ocampo et al. 54 |
| Case series | RA and MM | Adult (78, 72 and 60 years) | 3 | • Bortezomib 1.3 mg/sqm IV on days 1, 4, 8 and 11 + steroids for eight cycles for two patients, three cycles for one patient • Response: improvement of joint disease • No toxicity |
Lassoued et al. 55 |
APS, antiphospholipid syndrome; BM, bone marrow; CR, complete remission; Ig, immunoglobulins; IV, intravenous; MM, multiple myeloma; NR, non-response; PC, plasma cell; PR, partial remission; RA, rheumatoid arthritis; SLE, systemic lupus erythematosus.