DR. CORA LIM-MEDICAL INSIDER
Systemic Lupus Erythematosus
PART 6
This is now Part 6 of our discussion of Systemic Lupus Erythematosus.
Treatment
Research has it that Treatment of SLE includes the use of antimalarial drugs, corticosteroids, conventional immunosuppression with synthetic immunosuppressive medications, as well as biologic therapies and the detection and management of comorbidities.
The same research says that the aims of treatment are to induce remission of disease flares, and then maintain such remission.
The precise treatment administered is dependent on the severity of disease and the organ system involved.
Mild SLE can be treated with antimalarials (such as hydroxychloroquine) alone, but often stronger immunosuppression is also required.
Non-steroidal anti-inflammatory drugs are often considered to be contraindicated because of the increased cardiovascular risks, but very short term use for a defined period of time may be acceptable.
Management of lupus nephritis is based on early detection and diagnosis followed by treatment usually with mycophenolate mofetil or cyclophosphamide.
An increasing understanding of the pathogenesis of SLE and the involvement of B-cells, through both antibody dependent and independent mechanisms, has highlighted the importance of the loss of B-cell self-tolerance in driving autoimmunity in SLE.
This has shifted the focus of treatment towards novel, targeted therapies. (To be continued)