Systemic lupus erythematosus treatment strategies
Journal Title: Postępy Nauk Medycznych - Year 2012, Vol 25, Issue 2
Abstract
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by excess: autoantibody production; cytokine production; complement activation and diverse clinical consequences of these immunological abnormalities. The nature of the SLE is very heterogeneous. In the course of the disease a clinical pattern of flares and remissions can be observed. The management of SLE depends on disease, clinical manifestations; major organ involvement and comorbidities due to the disease or its treatment. The treatment of SLE varies according to an individual and disease severity. It is important to maintain an appropriate level of therapy to control or halt inflammatory disease activity while minimizing side effects and risk of infection and to prevent further major organ damage. Treatment plans are tailored to the individual’s needs and may change over time, depending on disease activity, different types of drugs are used. Corticosteroids can be applied on the skin in creams, while for people with joint or chest pain and fever non-steroidal anti-inflammatory drugs and other types of drugs to control pain, swelling and fever may be used. Antimalarials are drugs commonly used to treat lupus fatigue, joint pain, skin rashes and inflammation of the lungs. Continuous treatment with antimalarials may prevent flares from recurring. Coritcosteroids are the mainstay of SLE therapy. Cytotoxic agents suppress the immune system and are frequently used in SLE. Azathioprine, cyclofosphamide, mycophenolate mofetil, cyclosporine, methotrexate are most useful especially for patients whose kidneys and central nervous system are affected. In severe life-threatening type of the disease intravenous gammaglobulin, plasmapheresis and biologics may be considered as the therapy. In patients with secondary antiphospholipid syndrome a long-term treatment with low-dose aspirin, heparin or oral anticoagulants is recommended. Prophylaxis of cardio-vascular disease and osteoporosis is recommended for all patients with SLE.
Authors and Affiliations
Maria Majdan, Dorota Suszek, Andrzej Majdan
Keywords
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