[Current drug therapy of autoimmune diseases]

The aim of present-day chemotherapy treatment of chronic autoimmune diseases is to correct any disturbance in equilibrium of immune surveillance and to have a global immunosuppressive effect. Corticosteroids are the most important immunosuppressive agents. If they are administered three days out of four it is possible to preserve adrenal function. The addition of cytotoxic agents to steroids in immunosuppressive therapy allows one to preserve the immunosuppressive effect, while reducing the side effects of the steroid treatment. The use of alkylating agents must be limited because of their undoubted oncogenic effect, even though they are very effective immunosuppressive agents. Anti-lymphocyte-antithymocyte serum is a particular immunosuppressive method used primarily in autoimmune disorders associated with T lymphocyte pathology, as is cyclosporin A. Finally, plasma exchange in conjunction with immunosuppressive agents (methyl prednisolone + cyclophosphamide) administered intravenously as an intensive treatment is used only in patients with very active autoimmune disorders.