New treatment strategy including biological agents in patients with systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is a heterogeneous disease, in which B lymphocyte activation and chronic inflammation play the key role. Both the disease itself and its treatment cause damage to multiple organs and systems. So far, despite intensive treatment, disease remission has been achieved in few patients, and the ratio of organ complications has increased significantly. This is caused by a long‑term glucocorticoid therapy with a relatively rare use of immunosuppressive drugs. With a new treatment strategy and modern immunotherapy, it is possible to reduce the mortality rate, limit multiple‑organ damage, thereby significantly improving the quality of life and prognosis of patients with SLE. The "treat‑to‑target" strategy enables targeted treatment resulting in a long‑term symptom remission. It is based on an intensive immunosuppressive treatment with simultaneous reduction of glucocorticoid doses, and limiting their use solely to exacerbations in disease activity. The current idea for treatment is also the conscious use of the beneficial potential of background SLE treatment including antimalarial agents and standard immunosuppressive therapy. With the first biological agent approved for SLE treatment, the new age of therapy has dawned. Biologics offer new prospects and possibilities to induce clinical and immunological remission of SLE.