Tailored treatment strategies and future directions in systemic lupus erythematosus.


Journal

Rheumatology international
ISSN: 1437-160X
Titre abrégé: Rheumatol Int
Pays: Germany
ID NLM: 8206885

Informations de publication

Date de publication:
08 2022
Historique:
received: 07 03 2022
accepted: 02 04 2022
pubmed: 23 4 2022
medline: 20 7 2022
entrez: 22 4 2022
Statut: ppublish

Résumé

Systemic lupus erythematosus (SLE) represents a diagnostic and therapeutic challenge for physicians due to its protean manifestations and unpredictable course. The disease may manifest as multisystemic or organ-dominant and severity at presentation may vary according to age at onset (childhood-, adult- or late-onset SLE). Different manifestations may respond variably to different immunosuppressive medications and, even within the same organ-system, the severity of inflammation may vary from mild to organ-threatening. Current "state-of-the-art" in SLE treatment aims at remission or low disease activity in all organ systems. Apart from hydroxychloroquine and glucocorticoids (which should be used with caution), the choice of the appropriate immunosuppressive agent should be individualized and depend on the prevailing manifestation, severity stratification and patient childbearing potential. In this review, we provide an overview of therapeutic options for the various organ manifestations and severity patterns of the disease, different phenotypes (such as multisystem versus organ-dominant disease), as well as specific considerations, including lupus with antiphospholipid antibodies, childhood and late-onset disease, as well as treatment options during pregnancy and lactation.

Identifiants

pubmed: 35449237
doi: 10.1007/s00296-022-05133-0
pii: 10.1007/s00296-022-05133-0
doi:

Substances chimiques

Antibodies, Antiphospholipid 0
Glucocorticoids 0
Immunosuppressive Agents 0
Hydroxychloroquine 4QWG6N8QKH

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

1307-1319

Informations de copyright

© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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Auteurs

Dionysis Nikolopoulos (D)

Rheumatology and Clinical Immunology, 4th Department of Internal Medicine, "Attikon" University Hospital, Medical School National and Kapodistrian University of Athens, Athens, Greece. dsnikolopoulos@gmail.com.

Lampros Fotis (L)

Department of Pediatrics, "Attikon" University Hospital, Medical School National and Kapodistrian University of Athens, Athens, Greece.

Ourania Gioti (O)

Department of Rheumatology, "Asklepieion" General Hospital, Athens, Greece.

Antonis Fanouriakis (A)

Rheumatology and Clinical Immunology, 4th Department of Internal Medicine, "Attikon" University Hospital, Medical School National and Kapodistrian University of Athens, Athens, Greece.
1st Department of Propaedeutic Internal Medicine, "Laikon" General Hospital, Medical School National Kapodistrian University of Athens, Athens, Greece.

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