10 most important contemporary challenges in the management of SLE
From a 1-year survival of less than 50% before the discovery of glucocorticoids to over 90% at 10 years in most dedicated centres, the spectrum of SLE has profoundly evolved. Despite this improvement, several major challenges currently remain. The aim of this review is to analyse what are, according...
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| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2019-12-01
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| Series: | Lupus Science and Medicine |
| Online Access: | https://lupus.bmj.com/content/6/1/e000303.full |
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| _version_ | 1850065191071383552 |
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| author | Thierry Martin Pierre-Edouard Gavand Anne-Sophie Korganow Christelle Sordet Rose-Marie Javier Pauline Soulas-Sprauel Marianne Rivière Florence Scher Vincent Poindron Aurélien Guffroy |
| author_facet | Thierry Martin Pierre-Edouard Gavand Anne-Sophie Korganow Christelle Sordet Rose-Marie Javier Pauline Soulas-Sprauel Marianne Rivière Florence Scher Vincent Poindron Aurélien Guffroy |
| author_sort | Thierry Martin |
| collection | DOAJ |
| description | From a 1-year survival of less than 50% before the discovery of glucocorticoids to over 90% at 10 years in most dedicated centres, the spectrum of SLE has profoundly evolved. Despite this improvement, several major challenges currently remain. The aim of this review is to analyse what are, according to us, the 10 most important contemporary challenges in the management of SLE. Among those are the need to treat to target to favour disease remission (or low disease activity), limit the use of glucocorticoids, derive more comprehensive tools for the evaluation of disease activity, develop more effective drugs (yielding successful trials), dissect the heterogeneity of the disease both at the molecular and genetic levels, identify relevant biomarkers for individualised treatment, manage fertility and pregnancy, tackle comorbidities such as cardiovascular risk, the prevention of infections and osteoporosis, improve the network of care (from the patients’ perspective), and favour a holistic approach (integrating fatigue, adherence to treatment, physical activity). Altogether, these 10 contemporary challenges in SLE may be considered as a roadmap for those involved in the daily care of patients with SLE, as well as for researchers who may wish to contribute to an improved management of this rare and complex disease. |
| format | Article |
| id | doaj-art-1eecc545cac34fe386b95ef990290530 |
| institution | DOAJ |
| issn | 2053-8790 |
| language | English |
| publishDate | 2019-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Lupus Science and Medicine |
| spelling | doaj-art-1eecc545cac34fe386b95ef9902905302025-08-20T02:49:05ZengBMJ Publishing GroupLupus Science and Medicine2053-87902019-12-016110.1136/lupus-2018-00030310 most important contemporary challenges in the management of SLEThierry Martin0Pierre-Edouard Gavand1Anne-Sophie Korganow2Christelle Sordet3Rose-Marie Javier4Pauline Soulas-Sprauel5Marianne Rivière6Florence Scher7Vincent Poindron8Aurélien Guffroy92 Centre National de Références des Maladies Systémiques et Autoimmunes Rares Est Sud-Ouest (RESO)-LUPUS, Strasbourg, France2 Centre National de Références des Maladies Systémiques et Autoimmunes Rares Est Sud-Ouest (RESO), Université de Strasbourg, Strasbourg, France3 Service dimmunologie clinique, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France1 Service de rhumatologie, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France1 Service de Rhumatologie, Centre National de Référence des Maladies Auto-immunes Systémiques Rares Est Sud-Ouest (RESO), Hôpitaux universitaires de Strasbourg, Strasbourg, France3 Service dimmunologie clinique, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France4 Association Française du Lupus et autres Maladies Auto-Immunes (AFL+), France5 Service de Pharmacie-Stérilisation, Hôpitaux Universitaires de Strasbourg, Strasbourg, France3Centre National de Référence des maladies auto-immunes et systémiques rares Est/Sud-Ouest (RESO)3 Service dimmunologie clinique, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, FranceFrom a 1-year survival of less than 50% before the discovery of glucocorticoids to over 90% at 10 years in most dedicated centres, the spectrum of SLE has profoundly evolved. Despite this improvement, several major challenges currently remain. The aim of this review is to analyse what are, according to us, the 10 most important contemporary challenges in the management of SLE. Among those are the need to treat to target to favour disease remission (or low disease activity), limit the use of glucocorticoids, derive more comprehensive tools for the evaluation of disease activity, develop more effective drugs (yielding successful trials), dissect the heterogeneity of the disease both at the molecular and genetic levels, identify relevant biomarkers for individualised treatment, manage fertility and pregnancy, tackle comorbidities such as cardiovascular risk, the prevention of infections and osteoporosis, improve the network of care (from the patients’ perspective), and favour a holistic approach (integrating fatigue, adherence to treatment, physical activity). Altogether, these 10 contemporary challenges in SLE may be considered as a roadmap for those involved in the daily care of patients with SLE, as well as for researchers who may wish to contribute to an improved management of this rare and complex disease.https://lupus.bmj.com/content/6/1/e000303.full |
| spellingShingle | Thierry Martin Pierre-Edouard Gavand Anne-Sophie Korganow Christelle Sordet Rose-Marie Javier Pauline Soulas-Sprauel Marianne Rivière Florence Scher Vincent Poindron Aurélien Guffroy 10 most important contemporary challenges in the management of SLE Lupus Science and Medicine |
| title | 10 most important contemporary challenges in the management of SLE |
| title_full | 10 most important contemporary challenges in the management of SLE |
| title_fullStr | 10 most important contemporary challenges in the management of SLE |
| title_full_unstemmed | 10 most important contemporary challenges in the management of SLE |
| title_short | 10 most important contemporary challenges in the management of SLE |
| title_sort | 10 most important contemporary challenges in the management of sle |
| url | https://lupus.bmj.com/content/6/1/e000303.full |
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