Treatment of systemic lupus erythematosus

The treatment of systemic lupus erythematosus (SLE) is mainly based on a nu mber of "traditional" drugs such as corticosteroids, antimalarials, azathio prine and cyclophosphamide. However, this scenario is rapidly changing due to the introduction of new compounds. Some of these new agents have been su ccessfully used in other diseases, while others are being specifically desi gned to interfere with the immune abnormalities seen in SLE. As our knowledge on the mechanisms of immune response increases, new drugs that can interfere with T and B cell interaction and activation, production of anti-dsDNA autoantibodies, immune-complexes deposition and cytokine act ivation have been developed and some of these are now under investigation i n SLE. Although initial data regarding their safety and efficacy are encour aging, caution must be taken before these drugs are considered as the treat ment of choice for specific SLE manifestations. Specifically, controlled cl inical trials with sufficient number of patients are necessary. If the prom ising results already available are confirmed, the use of these drugs might represent the keystone in the future management of SLE and other autoimmun e diseases. (C) 2001 Elsevier Science B.V. All rights reserved.