Update on emerging drug therapies for systemic lupus erythematosus.
BACKGROUND
Despite the improvement in survival of systemic lupus erythematosus (SLE), a cure for this chronic and disabling disease is still a myth. Refractory manifestations and treatment-related complications are still major causes for mortality and morbidity. More effective but less toxic therapies through modification of existing regimens, combination strategies or more specific targeting at the immunopathogenetic pathways are necessary.


METHODS
The availability of biotechnology has led to the emergence of targeted therapies for SLE. In the past 5 years, there have been a number of clinical trials in the pipeline that involve existing drugs or novel biological agents. This article updates different novel therapeutic approaches in SLE that have emerged since 2006.


RESULTS
Readers will read the latest information and critical appraisals regarding recent clinical trials in lupus. Expert opinions on future directions of SLE treatment trials are also provided.


CONCLUSIONS
SLE is a clinically and immunologically heterogeneous disease. Targeted therapies are currently available but to the disappointment of the lupus community, data from many recent clinical trials are unfavorable. While flaws and limitations in the study design and outcome measures may contribute to the futility of these trials, selection of SLE subsets by serum and cellular biomarkers may identify those who will benefit from these targeted therapies.
Tuen Mun Hospital, Department of Medicine and Geriatrics, New Territories, Hong Kong, Japan. ccmok2005@yahoo.com
Chi Chiu
CC
Mok
D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000008:administration & dosage; D016503:Drug Delivery Systems / Q000379:methods; D004359:Drug Therapy, Combination; D015507:Drugs, Investigational / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007107:Immune System / Q000187:drug effects; D007155:Immunologic Factors / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D047589:Leukocyte Reduction Procedures / Q000379:methods; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy* / Q000276:immunology / Q000628:therapy; D018448:Models, Immunological; D015398:Signal Transduction / Q000187:drug effects; D033581:Stem Cell Transplantation / Q000379:methods
D000893:Anti-Inflammatory Agents; D015507:Drugs, Investigational; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide