**1.2 Most recent development for lupus treatment**

While lupus remains evasive in novel therapies with true benefit; one issue has been consistent, in that the preponderance of the evidence thus far, leads to B cell dysfunction. More recently Belimumab was indicated for use in lupus patients, which is an immunomodulator B-Lymphocyte Stimulator (BLyS)-Specific Inhibitor. This drug was approved by the Food and Drug Administration (FDA) for use in lupus patients in 2011 [2]. The majority of patients afflicted with lupus, autoreactive B-cells remain in the body longer than necessary. Belimumab binds to BLyS, causing it to no longer bind to and stimulate the autoreactive B cell.

Information recently discussed at the ACR2020, provides evidence of Belimumab standard therapy ameliorating the outcome for patients with active renal lupus. A combination of Belimumab, with either mycophenolate mofetil or Azathioprine, was shown to be more effective than either of these therapies alone. While studies are not yet conclusive, a combination of Belimumab with cyclophosphamide, posed no higher risk than cyclophosphamide alone. This combination in a class IV nephritis group exceeded those who received cyclophosphamide alone [3].

Anifrolumab, an interleukin-1 inhibitor, was not shown to be effective in systemic lupus, it did show promise in TULIP-1 and 2 and skin lesions related to lupus. Anifrolumab's effect on non-skin lupus disease activity however, was nominal [4].
