[Lupus erythematodes--evidence-based recommendations for monitoring and therapy]

Standard care of patients with systemic lupus erythematosus (SLE) covers continuous extended diagnostics including the search for new disease manifestations, evaluation of disease activity and of comorbidities requiring treatment and, in particular, accompanying infections. Immunosuppressive medication is determined by active organ manifestations and global disease activity, which is measured by standardized scores. In this context, it is important to differentiate between activity and damage, since damage is mostly treated symptomatically and, by definition, cannot be changed by immunosuppression. Activity and damage are the keystones estimating prognosis, especially since validated surrogate markers are lacking. The standard forms of immunosuppressive therapy for SLE have not changed in recent years, but the strategies are new. Antimalarials are indicated in every lupus patient as long as there are no contraindications. In proliferative nephritis, cyclophosphamide should be limited to the induction phase.