RECENT ADVANCES IN TREATMENT

Systemic lupus erythematosus (SLE) is a prototypic inflammatory autoimmune disorder characterized by multisystem involvement and fluctuating disease activity. Symptoms range from rather mild manifestations such as rash or arthritis to life-threatening end-organ manifestations such as glomerulonephritis or thrombosis .The current treatment of SLE mainly rests on glucocorticoids and immunosuppressive drugs, including alkylating agents, inhibitors of purine synthesis, and calcineurin inhibitors .However, due to the low therapeutic index of these agents many patients suffer from iatrogenic morbidity that can impair their quality of life and even their life-expectancy Moreover, a few patients do not respond to initial therapies or have frequent flares of lupus activity. The new therapeutic agents directed against specific targets involved in the pathogenesis of this disease, aim at improving efficacy and safety.The development of biological agents is a relatively recent addition to the pharmacologic armamentarium available to clinicians and promising results have been reported in some studies.The addition of novel biological therapy to the treatment of SLE has greatly changed the prognosis for SLE as regard the life expectancy, the disease control and the minimal side effects compared to the traditional immunosuppressive therapy.New biological therapy offer future hope for severe life threatening SLE manifestations not responding to the convential treatment. These therapies proved efficacy in treatment of lupus nephritis, CNS lupus, thrombotic thrombocytopenic purpura, CAPS and cutanous lupus.