title: Key issues in the management of patients with systemic lupus erythematosus: latest developments and clinical implications.
abstract: Systemic lupus erythematous (SLE) is a chronic multisystem disease with significant associated morbidity and mortality. A deeper understanding of the pathogenesis of SLE has led to the development of biologic agents, primarily targeting B cells and others inhibiting costimulatory molecules, type I interferons and cytokines such as interleukin-6. Several of these agents have been studied in clinical trials; some have shown promise while others have yielded disappointing results. Economic and regulatory issues continue to hamper the availability of such therapies for SLE patients. With increasing recognition that recurrent flares of disease activity lead to long-term damage accrual, one of the most important recent developments in patient management has been the concept of treat-to-target in SLE while minimizing patient exposure to excessive corticosteroid and other immunosuppressive therapy. This article reviews these key issues in SLE management, outlining recent developments and clinical implications for patients.
authors.affiliation: Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
authors.forename: Natasha
authors.initials: N
authors.lastname: Jordan
authors.affiliation: Louise Coote Lupus Unit, Guys Hospital, London, SE1 9RT, UK.
authors.forename: David
authors.initials: D
authors.lastname: D'Cruz
keywords: biologic therapies; long-term damage accrual; treat-to target