[Innovations in the pharmaceutical treatment of systemic lupus erythematosus].

Abstract

Background: Systemic lupus erythematosus (SLE) is a heterogeneous disease with a complex pathogenesis. Until now, the choice of therapeutic agents has been limited.

Objective: This review revisits known forms of treatment for SLE and introduces new recently approved agents and agents currently under investigation in clinical trials. The aim of this article is to map the current data from phase 2 and phase 3 studies and European recommendations for the management of SLE and to provide an outlook on the future of lupus treatment.

Data situation: As the focus of SLE treatment is on the achievement of remission with low steroid dosages, early and effective immunosuppressive therapy is essential. With the interferon type I receptor antagonist anifroluma, a treatment for extrarenal lupus has been approved for the first time since 2011. For lupus nephritis, the well-known belimumab (approval by the U.S. Food and Drug Administration, FDA and the European Medicines Agency, EMA) and the calcineurin inhibitor voclosporin (FDA) are newly available. In addition, a large number of substances are currently undergoing clinical trials, e.g. the CD-20 inhibitor obinutuzumab, Janus kinase inhibitors and low-dose interleukin‑2.

Conclusion: New and innovative treatment concepts are finding their way into lupus treatment and other promising substances are in the pipeline; however, only long-term data will show to what extent these improve the long-term outcome of patients. Nevertheless, these are important and much needed advances in the treatment of SLE.