New directions in the treatment of systemic lupus erythematosus

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Abstract
Objective: The aim of this review is to provide an up-to-date overview of treatment approaches for systemic lupus erythematosus (SLE), highlighting the multiplicity and heterogeneity of clinical symptoms that underlie therapeutic decisions. Discussion will focus on the spectrum of currently available therapies, their mechanisms and associated side-effects. Finally, recent developments with biologic treatments including rituximab, epratuzumab, tumor necrosis factor (TNF) inhibitors, and belimumab, will be discussed.Research design and methods: A MEDLINE literature search for ‘systemic lupus erythematosus’ and ‘damage’ and ‘treatment’ was undertaken for 1996–2008. Secondary citations were obtained from selected manuscripts. Individual case studies were excluded.Findings: SLE is an autoimmune disease involving multiple organ systems, a clinical pattern of flares and remissions, and the presence of anti-nuclear autoantibodies. Whereas early symptoms most frequently involve the skin and joints, disease...

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