Review: Systemic lupus erythematosus in children: current and emerging therapies

Treatment of children with systemic lupus erythematosus (SLE) is challenging. The therapeutic issues and risks and balances faced by adult patients are further complicated by an unpredictable disease course and long requirement for therapy in children with SLE. Further, non-compliance is a major obs...

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Bibliographic Details
Published in:Lupus 2007-08, Vol.16 (8), p.677-683
Main Authors: MacDermott, EJ, Adams, A., Lehman, Tja
Format: Article
Language:English
Subjects:
Cells
Compliance
Disease control
Immunotherapy
Lupus
Morbidity
Mortality
Pathogenesis
Pediatrics
Physicians
Remission (Medicine)
Rheumatology
Steroids
Teenagers
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Summary:Treatment of children with systemic lupus erythematosus (SLE) is challenging. The therapeutic issues and risks and balances faced by adult patients are further complicated by an unpredictable disease course and long requirement for therapy in children with SLE. Further, non-compliance is a major obstacle to satisfactory outcome which must be recognized and dealt with in every adolescent in our efforts to attain optimal outcome. Treatment with combinations of cytotoxic agents and biologics which result in significant B-cell depletion often provide improved disease control. As our knowledge of the pathogenesis of SLE delineates more specific targets for immunotherapy the incidence of long-term remission rises. Our current emphasis is on therapeutic regimens which will induce remission followed by maintenance therapy in the oncologic model. SLE like neoplastic disease is no longer simply `treatable'. With appropriate therapy many children with SLE attain sustained remissions. In the foreseeable future childhood SLE may be curable. Lupus (2007) 16, 677—683.
ISSN:0961-2033
1477-0962
DOI:10.1177/0961203307079567