Efficacy and safety of TNF-blocker therapy in systemic lupus erythematosus.
BACKGROUND
There is still unmet medical need in the therapy of severe organ manifestations of patients with systemic lupus erythematosus (SLE). Therapeutic agents targeting pro-inflammatory cytokines may be an interesting option.


OBJECTIVE
To review available data on the efficacy and safety of tumour necrosis factor (TNF) blockade in SLE.


METHODS
A review of the literature was conducted.


CONCLUSIONS
Open-label experience suggests that TNF blockade is effective in SLE patients with arthritis, nephritis and skin disease. In particular, nephritis may remain in long-term remission after just four infusions of infliximab administered. Despite the induction of lupus-specific autoantibodies, short-term therapy with infliximab in combination with azathioprine appears feasible and relatively safe. The data call for controlled clinical trials, at least one of which has been initiated.
Aringer
Martin
M
University Clinical Center Carl Gustav Carus, Technical University of Dresden, Division of Rheumatology, Department of Medicine III, Fetscherstrasse 74, 01307 Dresden, Germany. martin.aringer@uniklinikum-dresden.de
Smolen
Josef S
JS
D018501:Antirheumatic Agents / Q000009:adverse effects / Q000494:pharmacology*; D001168:Arthritis / Q000188:drug therapy / Q000209:etiology; D001323:Autoantibodies / Q000187:drug effects; D002986:Clinical Trials as Topic; D016503:Drug Delivery Systems; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy* / Q000503:physiopathology; D009393:Nephritis / Q000188:drug therapy / Q000209:etiology; D012074:Remission Induction / Q000379:methods; D012867:Skin / Q000187:drug effects / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000378:metabolism
D018501:Antirheumatic Agents; D001323:Autoantibodies; D014409:Tumor Necrosis Factor-alpha