Vol 4, No 2 (2018)
Review paper
Published online: 2018-08-17
Treatment of systemic lupus erythematosus — future challenges and prospects
Forum Dermatologicum 2018;4(2):70-77.
Abstract
Systemic lupus erythematosus is a chronic, multi-systemic autoimmune condition characterized by a highly unpredictable course involving flares and remissions. Long term outcome of lupus patients has dramatically improved over the last decades due to widespread introduction of potent therapies. Nevertheless, chronic corticosteroid exposure and wide-spectrum immunosuppression are major contributors to organ function deterioration and infective complications. Cumulative toxicity over time results in appreciably shortened life span with significant mortality rates among patients with refractory disease or lupus nephritis. Complex nature of the disease itself, limited understanding of the pathogenesis and the lack of reliable outcome measures are the main reasons for difficulties in demonstrating a novel effective therapy, therefore biologic modalities are still limited in systemic lupus erythematosus. Continuous efforts are being made to develop more selective and less-toxic innovative therapies that would enable tight disease control and improve the prognosis. Identification of novel treatment targets and adequate clinical trials design are sine qua non conditions to confirm drugs’ efficacy and have them approved by regulatory agencies.
Keywords: systemic lupus erythematosustherapeuticspathogenesis
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