Abstract

Introduction

GcMAFanti is a Gc protein-derived macrophage-activating factor that enhances macrophage phagocytic activity and stimulates the production of anti-inflammatory cytokines. The aim of this study was to describe the clinical picture of monotherapy in the treatment of systemic lupus erythematosus.

Case Presentation

The patient (female, 37 years old) was diagnosed with systemic lupus erythematosus according to the EULAR/ACR 2019 diagnostic criteria. The patient had elevated titers of antinuclear antibodies, recurrent episodes of fever, a low C4 level, and a high level of anti-dsDNA antibodies. The activity of systemic lupus erythematosus was low, 5 points on the SLEDAI-2K scale. The patient was transitioned to GcMAFanti monotherapy after two years of standard therapy with hydroxychloroquine and prednisolone. A total of four courses of subcutaneous GcMAFanti injections were administered, each consisting of 12 injections over 24–36 days (a single 2–5 μg injection every 2–3 days), with 2–4-month intervals between treatment courses. GcMAFanti monotherapy did not reverse the positive clinical changes in the patient achieved by standard therapy with hydroxychloroquine and prednisolone. No febrile episodes were observed during therapy and for 2–3 months following treatment; neither patient-reported complaints nor adverse events were reported during the same period. The result of GcMAFanti monotherapy was 2- 4 points on the SLEDAI-2K scale. Indicators of immunobiological markers of systemic lupus erythematosus indicated stabilization of the disease with GcMAFanti monotherapy.

Conclusion

The results obtained in this case report of systemic lupus erythematosus treatment using the novel agent GcMAFanti suggest that clinical studies are required to further analyze the effect of GcMAFanti on systemic lupus erythematosus.

Keywords: Systemic lupus erythematosus, Antigen-presenting cell, Macrophage, Interleukin-10, Transforming growth factor beta, Vitamin D-binding protein.
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