Management strategies for systemic lupus erythematosus using kinase inhibitors

Systemic lupus erythematosus (SLE) is a chronic, multisystem autoimmune disease that is undergoing a revolution in its treatment paradigm. Receptor kinases including Janus (JAK) kinases, Bruton's tyrosine kinase (BTK), and spleen tyrosine kinase (SYK) are essential for signalling of many cytokines and receptors on immune cells. Suppression of these kinases changes the activation state of target cells, leading to inhibition of cytokine actions and effects such as autoantibody secretion. Therefore, therapeutic kinase inhibitors hold potential as treatments for SLE, but their efficacy and safety remain to be determined. Tyrosine kinase 2 and JAK inhibitors such as deucravacitinib and upadacitinib respectively have shown positive results in phase 2 trials, while further research into the JAK inhibitor baricitinib and BTK and SYK inhibitors has been less encouraging. This review summarises the current state of research on the use of kinase inhibitors in SLE.