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Temporary Withholding of Immunosuppressant in Rheumatic diseases and Lupus (TWIRL) Study

Mycophenolate is an immunosuppressant that is widely used as a treatment for systemic lupus erythematosus (SLE). It targets immune cell functions, reducing systemic or organ related inflammation and damage. The benefits of using mycophenolate need to be carefully balanced against unintended side effects, like increased risk of infection or blunting of vaccine responses. One strategy which we are currently testing in a cohort of people with SLE is to temporarily withdraw this immunosuppressant, allowing for the immune system to recover and theoretically improve responses to vaccines or infections.

To determine if temporarily withdrawing specific immunosuppressants can enhance vaccine immune responses in people living with SLE. 

2023 - Ongoing

In collaboration with clinicians at Monash Health we will be performing an intervention study testing if withdrawal of Mycophenolate, for 2 weeks, improves immune responses to seasonal influenza vaccination compared to patients who remain on Mycophenolate.  The Antiviral Immunity team will measure serological and cellular responses to seasonal influenza vaccinations. 

Immunogenicity and safety of vaccination in SLE patients has been of significant interest to clinicians, but limited data are available. We anticipate that SLE patients who have had temporary interruption of immunosuppression will have improved antibody responses. The findings from this study will be used to develop new evidence-based guidelines to improve clinical care of SLE patients.

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Doctor Gabriela Khoury

Contact Doctor Gabriela Khoury for more information about this project.

EMAIL

Funding
Partners

  • Arthritis Australia
  • Burnet Institute

Partners +
Collaborators

  • Monash Health: A/Prof Alberta Hoi, A/Prof Ian Woolley and A/Prof Claire Dendle.