An update on the management of refractory cutaneous lupus erythematosus

Abstract

Management of cutaneous lupus erythematosus (CLE) involves a combination of preventive measures, topical and systemic drugs, fairly similar for the different subtypes. Although guidelines exist, to date, no specific drugs have been specifically licensed for CLE. Antimalarials remain the first-line systemic treatment, but many patients do not respond, making refractory lupus a challenge for clinicians. The choice of alternative medication should be based on effectiveness, safety and cost. Most of the available drugs for CLE have been adapted from systemic lupus erythematosus (SLE) treatment but the existing literature is limited to small studies and evidence often lacks. As knowledge of pathogenesis of both CLE and SLE is improving, promising new therapies are emerging. In this review, we discuss the available medications, focusing on the novelties under development for CLE.

Chronic hepatitis B in rheumatic diseases: issues of screening and reactivation of infection: A review

“…Традиционно наиболее опасными в этом плане считаются анти-В-клеточные препараты, способствующие подавлению выработки специфических антител. В недавно вышедшей статье, посвященной обновленной информации о лечении рефрактерной кожной красной волчанки ритуксимабом, отдельно упоминается HBV-r как cерьезная, потенциально летальная нежелательная реакция, зарегистрированная Управлением по контролю пищевых продуктов и лекарств в США (Food and Drug Administration -FDA) [19]. В некоторых случаях новые данные не подтверждают имеющиеся или противоречат им (табл.…”

A Review of the Potential Benefits of Herbal Medicines, Small Molecules of Natural Sources, and Supplements for Health Promotion in Lupus Conditions

“…(16) primary outcome-immunomodulationwas the intervention statically effective? (17) primary outcome-other organ systemswas the intervention statically efficacious? (18) the reported adverse effects for molecules or extracts; (19) the reported interaction (with drugs, food, or herbs) for the tested molecules or extracts.…”

“…Some previous articles can be found on the treatment of lupus conditions that are not on natural products or supplements and mostly discussed orthodox medicine [13][14][15][16][17][18]. Some other review articles discussing natural products on a specific condition of lupus, such as cutaneous lupus [19] or lupus nephritis [20], can be found in the literature.…”

Synthetic Pharmacotherapy for Systemic Lupus Erythematosus: Potential Mechanisms of Action, Efficacy, and Safety

“…EULAR recommends the use of dapsone at a dose of 100 mg per day in patients with BSLE who do not respond to or require high doses of GC [ 309 ]. However, it is common to start with a dose of 50 mg per day, which is titrated according to response and tolerance up to a maximum of 200 mg per day [ 300 , 309 ].…”