title: Drugs in early clinical development for Systemic Lupus Erythematosus.
abstract: BACKGROUND
  While immunosuppressive therapy has positively impacted the prognosis of systemic lupus erythematosus (SLE), many patients still do not respond to traditional therapy. Thus, active SLE disease remains a significant problem. Furthermore, conventional immunosuppressive treatments for SLE are associated a high risk of side effects. These issues call for improvement in our current therapeutic armamentarium.
  
  
  METHODS
  In this review, the authors highlight the recent developments in therapies for SLE, and present an overview of drugs which are in early clinical development for SLE. There are many new therapeutic approaches being developed, including those focused on B-cell targets, T-cell downregulation, co-stimulatory blockade, anti-cytokine agents, and kinase inhibition, and Toll-like receptor inhibition. They also discuss peptide therapy as a potential method to re-establish immune tolerance, and some of the challenges ahead in developing and testing novel agents for SLE.
  
  
  CONCLUSIONS
  Many novel agents are currently in development for SLE, but this encouraging news is tempered by several disappointments in clinical trials and provides a timely moment to reflect on the future of therapeutic development in SLE. It seems likely that biological heterogeneity between patients is a major contributor to difficulty in drug design in SLE.
authors.affiliation: a Rheumatology Unit, Department of Medicine, Faculty of Medical Science , State University of Campinas , Campinas , Brazil.
authors.forename: Mariana
authors.initials: M
authors.lastname: Postal
authors.affiliation: a Rheumatology Unit, Department of Medicine, Faculty of Medical Science , State University of Campinas , Campinas , Brazil.
authors.forename: Nailú Angélica
authors.initials: NA
authors.lastname: Sinicato
authors.affiliation: a Rheumatology Unit, Department of Medicine, Faculty of Medical Science , State University of Campinas , Campinas , Brazil.
authors.forename: Simone
authors.initials: S
authors.lastname: Appenzeller
authors.affiliation: b Division of Rheumatology, Department of Immunology , Mayo Clinic , Rochester , MN , USA.
authors.forename: Timothy B
authors.initials: TB
authors.lastname: Niewold
mesh_terms: D000818:Animals; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy*
chemical_list: D007166:Immunosuppressive Agents
keywords: Systemic lupus erythematosus; b cell; cytokine; t cell