title: When biologics should be used in systemic lupus erythematosus?
abstract: Recently, the use and evaluation of biologics increased in systemic lupus erythematosus (SLE). However, no international recommendation is available concerning the use of biologics with regards to the subset of patients who should be treated, the optimal time to treat, the objective of treatment and the manner to discontinue it. To address these complex questions, we focused on biologics already evaluated in at least two published randomized controlled trials. We summarized the results of these trials and available observational data in registries. Taking into account the clinical evidence, we proposed some guidance on the way biologics could be used in SLE. Many areas of uncertainty persist and require intensifying efforts from the academic world to set up new trials, and develop international recommendations.
authors.affiliation: Hôpitaux universitaires de Strasbourg, Centre de référence national pour les maladies auto-immunes systémiques rares, service de rhumatologie, 67000 Strasbourg, France. Electronic address: jacques-eric.gottenberg@chru-strasbourg.fr.
authors.forename: Jacques-Eric
authors.initials: JE
authors.lastname: Gottenberg
authors.affiliation: Hôpitaux universitaires de Strasbourg, Centre de référence national pour les maladies auto-immunes systémiques rares, service de rhumatologie, 67000 Strasbourg, France.
authors.forename: Noël
authors.initials: N
authors.lastname: Lorenzo
authors.affiliation: Hôpitaux universitaires de Strasbourg, Centre de référence national pour les maladies auto-immunes systémiques rares, service de rhumatologie, 67000 Strasbourg, France.
authors.forename: Christelle
authors.initials: C
authors.lastname: Sordet
authors.affiliation: Hôpitaux universitaires de Strasbourg, Centre de référence national pour les maladies auto-immunes systémiques rares, service de rhumatologie, 67000 Strasbourg, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Theulin
authors.affiliation: Hôpitaux universitaires de Strasbourg, Centre de référence national pour les maladies auto-immunes systémiques rares, service de rhumatologie, 67000 Strasbourg, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Chatelus
authors.affiliation: Hôpitaux universitaires de Strasbourg, Centre de référence national pour les maladies auto-immunes systémiques rares, service de rhumatologie, 67000 Strasbourg, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Sibilia
mesh_terms: D000069594:Abatacept; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D001688:Biological Products / Q000627:therapeutic use*; D006801:Humans; D018796:Immunoconjugates / Q000627:therapeutic use; D007155:Immunologic Factors / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D000069283:Rituximab
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D058846:Antibodies, Monoclonal, Murine-Derived; D001688:Biological Products; D018796:Immunoconjugates; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D000069283:Rituximab; C511911:belimumab; D000069594:Abatacept