Pharmacotherapy in Systemic Lupus Erythematosus

This article explores the strategies of systemic lupus erythematosus (SLE) Pharmacotherapy. SLE is a multisystem autoimmune disease, which affects different tissues and organs in the body, causing damage and dysfunction. Some patients with lupus have a very mild disease that can be treated with simple medications, whereas others have serious, lifethreatening complications. Treatments vary according to the variability in the clinical presentation of disease, and should be highly individualized. Optimal care of the patient with SLE includes education and support services in addition to the pharmacologic and non-pharmacologic treatments. Drug therapy for SLE is often designed to suppress the immune response and inflammation. Minor manifestations can be treated with, less toxic agents, such as non-steroidal antiinflammatory drugs, topical intra-lesion corticosteroids, and anti-malarial drugs. Aggressive therapy with high-dose corticosteroids is necessary in patients with worsening lupus nephritis. Central Nervous System (CNS) lupus has responded in various degrees to dexamethasone and methylprednisolone. Immunosuppressive have become the gold standard for the treatment of major organ involvement in SLE. The treatment of moderate to severe disease comprises initially a period of intensive immunosuppressive therapy aimed at halting immunological injury followed by less aggressive maintenance therapy to consolidate remission and reduce the risk of flares. Recently, specific drugs are used as adjuvants to the previous therapy including intravenous immunoglobulins (IVIg), plasmapharesis, and dehydroepiandrosterone (DHEA). However, most drugs are associated with certain levels of toxicity therefore it is important to understand the toxicity profiles of these drugs and their implications on management in order to offer sound medical care.