[Unmet needs in systemic lupus erythematosus].

Area of Science:

• Rheumatology
• Immunology
• Internal Medicine

Background:

• Systemic lupus erythematosus (SLE) is a complex autoimmune disorder characterized by inflammation and autoantibody production.
• Lupus nephritis (LN) and neuropsychiatric SLE (NPSLE) are severe manifestations impacting patient morbidity and mortality.
• While survival rates have improved with steroids and immunosuppressants, treatment challenges and complications persist.

Purpose of the Study:

• To review the unmet needs in diagnosing and treating SLE, focusing on LN and NPSLE.
• To highlight the limitations of current diagnostic criteria for early SLE detection.
• To discuss emerging therapeutic strategies for refractory SLE manifestations.

Main Methods:

• Review of existing literature on SLE diagnosis and treatment.
• Analysis of current therapeutic approaches, including steroids, immunosuppressants, and novel agents.
• Discussion of diagnostic criteria and the need for new biomarkers.
• Incorporation of the authors' clinical experience with SLE, LN, and NPSLE.

Main Results:

• Current SLE diagnostic criteria (ACR 1997, SLICC 2012) are insufficient for early diagnosis.
• Established treatments improve long-term survival but are associated with complications.
• Biologic agents and small molecules show promise for refractory LN and NPSLE.
• There is a critical need for novel biomarkers for early SLE detection.

Conclusions:

• Significant unmet needs exist in the early diagnosis and treatment of SLE, particularly for LN and NPSLE.
• Novel biomarkers are essential for timely SLE diagnosis and intervention.
• Emerging therapies offer hope for managing severe and refractory SLE manifestations.
• A comprehensive approach addressing both diagnostic and therapeutic gaps is crucial for improving patient outcomes.