SynthesisDermatology online journal2026
Targeted therapies against type I interferon and TNF-alpha in cutaneous lupus erythematosus: A systematic review of randomized trials.
Synthesis in Dermatology online journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
6 authors.
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Abstract
Background: Cutaneous lupus erythematosus (CLE) is associated with high symptomatic burden and sustained activation of immune pathways, notably type I interferon (IFN-I) and tumor necrosis factor-alpha (TNF-α). In patients refractory to standard treatments, such as photoprotection, corticosteroids, antimalarials, and immunomodulators, targeted therapies have emerged as potential alternatives. Objective: To assess the efficacy and safety of targeted therapies against IFN-I or TNF-α compared to standard treatments in patients with CLE. Methods: A systematic review was conducted of randomized controlled trials (RCTs) involving adults or adolescents with CLE (with or without systemic lupus erythematosus), reporting cutaneous outcomes (CLASI-A, CLASI-50, responder rates) and safety. Literature searches were performed in MEDLINE, Embase, and LILACS without language restrictions. Risk of bias was evaluated using the Cochrane RoB 2 tool. Owing to clinical heterogeneity, results were synthesized narratively. Results: Eight RCTs met inclusion criteria, predominantly evaluating IFN-I pathway inhibitors. Anifrolumab showed significant benefit in TULIP-2 (CLASI-50: 49% vs 25%; P = .001) and MUSE (63% vs 30.8%). Sifalimumab achieved CLASI-50 responses up to 73%. Deucravacitinib (TYK2 inhibitor) and BIIB059 (anti-BDCA2) also showed clinical improvements. RSLV-132 and epratuzumab did not demonstrate efficacy. IFN-I blockade was associated with increased viral infections, particularly herpes zoster. Two studies were rated as high risk of bias; the remainder presented some concerns. Conclusion: Targeted inhibition of IFN-I and TYK2 pathways appears effective in reducing cutaneous activity in CLE, with acceptable safety profiles. Evidence for anti-TNF therapies remains insufficient. Further trials stratified by CLE subtype and patient-reported outcomes are warranted to inform clinical guidelines.
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Registered trials
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