Therapeutic Perspectives in Systemic Lupus Erythematosus

Prognosis in systemic lupus erythematosus (SLE) has improved markedly in the last 40 years. From mortality rate which was higher than 50% after 5 years of SLE diagnosis in the 60's to a more than 90% survival after 10 years in the more recent prospective studies [1]. This is probably due to a number of reasons, including a better knowledge of the disease (earlier and easier diagnosis, assessment of new subsets) and an improved general healthcare (new antibiotics or better drugs to treat hypertension or hyperlipidemia, development of intensive therapy units), but also to the introduction of non-specific anti-inflammatory drugs, immunosuppressors and immunomodulators (steroids, cytostatics, intravenous gammaglobulins). Future challenges are to improve the quality of life of these patients and to reduce even more the mortality - the current mortality is still 3-4 times higher then expected for the similar age and gender population. In order to achieve these objectives, three main goals should be addressed: 1) to improve the use of some drugs already available; 2) to introduce some drugs in the clinical practice that are currently in phase I-III trials; and 3) to increase the basic research in order to discover targets for new selective immunomodulators.