POS0716 EFFICACY AND SAFETY OF LOW-DOSE IL-2 IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

Abstract

BackgroundSystemic lupus erythematosus (SLE) is an autoimmune disease characterized by disturbances of regulatory and effector CD4+T cells, which were regulated by interleukin (IL)-21,2.ObjectivesThe aim of this study was to systematically evaluate the efficacy and safety of low-dose IL-2 therapy in SLE treatment.MethodsSystematic searches of PubMed, EMBASE, Web of Science, the Cochrane Library and Medline, CNKI, CBM and Technology Journal Database were performed. Original case reports, case series, observational studies and clinical trials reporting the efficacy or safety data on SLE patients treated with IL-2 were included. A random-effects meta-analysis was performed to calculate the pooled efficacy. Inconsistency was evaluated by using the I2 and Egger tests were used for the evaluation of potential publication bias (STATA v.12.0).ResultsA total of 7 studies comprising 327 patients were identified (Table 1). After the low-dose IL-2 treatment, 54.8% Lupus nephritis patient had distinct clinical remission. The SRI-4 response rates were 0.816 (95%CI 0.730-0.901) and the SELENA-SLEDAI scores were significantly decreased [SMD=-2.504, 95%CI (-4.089,-0.919), P=0.002]. Injection site reaction and fever, which were common side effects for IL-2, occurred in 33.1% and 14.4% of patients, None serious adverse events were reported among all these studies. Besides, the proportions of CD4+T cells and Tregs were significantly increased after IL-2 injection [SMD=0.600, 95%CI (0.108,1.093), P=0.017; SMD=1.168, 95%CI (0.429,1.908), P=0.002], while there were no statistical differences in the proportions of CD8+T cells, Th17 cells, Th1 cells and Th2 cells between before and after IL-2 treatment (P>0.05)(Figure 1).Table 1.Available evidence including patients with SLE treated with low-dose IL-2.Study. Year. (design)Patients (include in analysis)Gender (female %)DosageSRI-4,n(%)SELENA–SLEDAIRemission (%)Jing He.60(30)90.001 million IU every other day16 (55.17)0 w: 12.00±4.7553.852019. (PCT)12 w: 6.00±4.00Jing He.40(23)92.501 million IU every other day34 (89.50)0 w: 11.14±3.79NA2016. (PCT)12 w: 3.92±2.23Miao Shao.30(18)88.891 million IU every other dayNANA55.562019. (PCT)Chunmiao Zhao.50(50)94.001 million IU, 3-5d/monthNA0 w: 5.92±0.36NA2019. (PCT)12 w: 4.05±0.31Shengxiao Zhang. 2019. (PCT)495(54)NA0.5 million IU per day for 5 daysNANANAKai Fan.106(76)NA0.5 million IU per day for 5 daysNANANA2018. (PCT)Jing Wang.76(76)93.420.5 million IU per day for 5 daysNA0 d: 10.87±6.48NA2017. (PCT)5 d: 5.83±4.18ConclusionLow-dose IL-2 was promising and well-tolerated in the treatment of SLE, which could promotes the proliferation and functional recovery of Tregs.