[Pathogenesis and new therapeutic approaches for systemic lupus erythematosus]

Systemic lupus erythematosus is a complex autoimmune disease that can affect multiple organs and is characterized by a loss of peripheral tolerance against nuclear antigens, pathogenic B and T cell responses and production of autoantibodies. The prevalence is estimated to be 40 per 100,000 in the population in Europe but can be as high as 150 patients per 100,000 among the Afro-Caribbean population. Although the 5-year survival rate in the 1950s was estimated to be only 50%, the 10-year survival rate is currently estimated to be 70-92%. This progress is particularly due to a better understanding of the pathogenesis that opened up better therapeutic possibilities in the past and now raises new perspectives for future therapy approaches.

The current knowledge on the pathogenesis and the current situation of new therapeutic approaches for SLE are presented.

This progress in the therapeutic options was made possible by a better understanding of the pathophysiology, which leads to the expectation of an improvement in the prognosis of patients due to reduction in the burden of the disease in the future. Several new therapeutic medications are currently awaiting approval and recently for the first time in more than 50 years a new medication for SLE was approved, a monoclonal antibody to the tumor necrosis factor (TNF)-like ligand, B-cell activating factor (BAFF) belonging to the TNF family also named B-cell lymphocyte stimulator (BLyS), BAFF/BLyS.