Pharmacotherapy in Systemic Lupus Erythematosus
Layla E. Borham.
This article explores the strategies of systemic lupus erythematosus (SLE) Pharmacotherapy. SLE is a multisystem
autoimmune disease, which affects different tissues and organs in the body, causing damage and dysfunction. Some
patients with lupus have a very mild disease that can be treated with simple medications, whereas others have serious, lifethreatening
complications. Treatments vary according to the variability in the clinical presentation of disease, and should
be highly individualized. Optimal care of the patient with SLE includes education and support services in addition to the
pharmacologic and non-pharmacologic treatments. Drug therapy for SLE is often designed to suppress the immune response
and inflammation. Minor manifestations can be treated with, less toxic agents, such as non-steroidal antiinflammatory
drugs, topical intra-lesion corticosteroids, and anti-malarial drugs. Aggressive therapy with high-dose corticosteroids
is necessary in patients with worsening lupus nephritis. Central Nervous System (CNS) lupus has responded in
various degrees to dexamethasone and methylprednisolone. Immunosuppressive have become the gold standard for the
treatment of major organ involvement in SLE. The treatment of moderate to severe disease comprises initially a period of
intensive immunosuppressive therapy aimed at halting immunological injury followed by less aggressive maintenance
therapy to consolidate remission and reduce the risk of flares. Recently, specific drugs are used as adjuvants to the previous
therapy including intravenous immunoglobulins (IVIg), plasmapharesis, and dehydroepiandrosterone (DHEA). However,
most drugs are associated with certain levels of toxicity therefore it is important to understand the toxicity profiles of
these drugs and their implications on management in order to offer sound medical care.
Keywords: Systemic lupus erythematosus (SLE), pharmacotherapy, anti-inflammatory drugs, immunosuppressive drugs, immunomodulators.
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