2022 Systemic lupus erythematosus remission in clinical practice. Message for Polish rheumatologists

Abstract

Systemic lupus erythematosus (SLE) is a complicated multiorgan disease and can lead to organ damage and increased risk of morbidity and mortality. The strategy of management while avoiding complications, especially caused by chronic glucocorticoid therapy, improves outcomes. Different definitions of the treatment goal in different configurations of lupus activity indexes have appeared over the years. In 2021 the definition of remission and recommendations for its achievement were published and it become a way to implement a treat-to-target strategy. The main goal of treatment has become DORIS (definition of remission in SLE) remission and the alternative LLDAS (low lupus disease activity state). Prolonging remission with clinical and immunological lupus activity restrictions and minimizing or stopping steroid doses reduced flares and damage accrual. The analysis and neutralization of poor prognosis predictive factors in lupus could be the most beneficial for less morbidity and mortality and better quality of life.

Unraveling transcriptomic signatures and dysregulated pathways in systemic lupus erythematosus across disease states

“…The treatment goal is to achieve complete remission (SLEDAI = 0) or Low Lupus Disease Activity State (LLDAS) (SLEDAI ≤ 4), as patients experiencing longer periods in these states demonstrate improved clinical outcomes [ 6 , 7 ]. While over 50% of SLE patients achieve remission through immunosuppressant treatments, permanent remission remains uncommon, and many patients experience flare-ups [ 8 – 11 ]. As such, understanding the molecular signature at various time points during the disease course is essential for developing personalized and effective treatments for different stages of SLE.…”

Generalized lymphadenopathy in the presence of acute Epstein–Barr virus infection as the initial manifestation of systemic lupus erythematous: A case report

“…Systemic lupus erythematous (SLE) is a complex heterogenous disease with variable clinical presentations. 1 The prevalence of SLE was reported 40/100,000 among Iranian population. 2 Pathogens have proposed to cause autoimmunity.…”

Efficacy of baricitinib in the treatment of Systemic lupus erythematosus (SLE): A Systemic review and meta-analysis

“…This drug is being investigated as a potential therapeutic option for SLE [ [6] , [7] , [8] , [9] ]. The SLE Responder Index-4 (SRI-4), a composite endpoint that measures clinical improvement in disease activity, has been used as the primary outcome measure in several clinical trials investigating the efficacy of baricitinib in SLE [ 10 ].Low lupus disease activity state (LLDAS), a more stringent endpoint has also been proposed as a potential alternative target in lupus treatment [ 11 ].…”