Systemic lupus erythematosus: state of the art on clinical practice guidelines

Abstract

Systemic lupus erythematosus (SLE) is the paradigm of systemic autoimmune diseases characterised by a wide spectrum of clinical manifestations with an unpredictable relapsing-remitting course. The aim of the present work was to identify current available clinical practice guidelines (CPGs) for SLE, to provide their review and to identify physicians’ and patients’ unmet needs. Twenty-three original guidelines published between 2004 and 2017 were identified. Many aspects of disease management are covered, including global disease management, lupus nephritis and neuropsychiatric involvement, management of pregnancies, vaccinations and comorbidities monitoring. Unmet needs relate with disease management of some clinical manifestations and adherence to treatment. Many patient’s unmet needs have been identified starting with faster diagnosis, need for more therapeutic options, guidelines on lifestyle issues, attention to quality of life and adequate education.

Relationship between Neutrophil-to-Lymphocyte Ratio and Systemic Lupus Erythematosus: A Meta-analysis

“…Chronic inflammation stimulated by environmental and genetic factors is a common characteristic in most autoimmune diseases including SLE (10,11). The immune system of SLE patients is aberrantly activated by autoantigens, resulting in immune complex deposition, complement system activation, and chronic inflammation (1,2,6,7). Additionally, several inflammatory markers, such as C-reactive protein, erythrocyte sedimentation rate, and interferon, are positively associated with SLE progression.…”

“…Systemic lupus erythematosus (SLE) is a chronic systematic autoimmune disease with high heterogeneity (1,2). SLE is more prevalent in women of reproductive age than in men (3)(4)(5).…”

“…SLE is more prevalent in women of reproductive age than in men (3)(4)(5). Although the etiology and pathogenesis of SLE have not been fully elucidated, the breakdown of immune tolerance induced by environmental stimulation and genetic factors is widely reported to play a core role in SLE (1,2,6,7). The typical characteristics of SLE mainly include autoantibody production, aberrant complement system activation, immune complex deposition, and chronic inflammation, usually leading to multiple organ damage as well as diverse clinical manifestations (1,2,6,7).…”

“…The disease activity of SLE is related to its distinct pathogenesis and diverse clinical manifestations; thus, the treatment of SLE should be timely adjusted according to the changes in disease activity (2). The Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) score is most commonly applied to assess SLE disease activity (8).…”

“…However, it holds great significance in identifying reliable, practical, and economical biomarkers to assist in diagnosing SLE and quantifying the disease activity of SLE patients. The immune system of SLE patients is abnormally activated by autoantigens, which results in immune complex deposition and complement system activation, followed by chronic inflammation (1,2,6,7,9). Furthermore, chronic inflammation stimulated by environmental and genetic factors is a common characteristic of autoimmune diseases including SLE (10,11).…”