4.5 Review

Advances in the management of systemic lupus erythematosus

Journal

BMJ-BRITISH MEDICAL JOURNAL
Volume 383, Issue -, Pages -

Publisher

BMJ PUBLISHING GROUP
DOI: 10.1136/bmj-2022-073980

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This review provides a comprehensive summary of the current status of systemic lupus erythematosus, including recent advances in genetics and immunological pathogenesis, as well as the latest guidelines and strategies for diagnosis, classification, and treatment. The paper also reviews numerous recent clinical trials in SLE and suggests future research directions. The findings of these studies should contribute to personalized treatment, minimizing side effects, and achieving better outcomes in this challenging disease.
Systemic lupus erythematosus (SLE) is a severe multisystem autoimmune disease that can cause injury in almost every body system. While considered a classic example of autoimmunity, it is still relatively poorly understood. Treatment with immunosuppressive agents is challenging, as many agents are relatively nonspecific, and the underlying disease is characterized by unpredictable flares and remissions. This State of The Art Review provides a comprehensive current summary of systemic lupus erythematosus based on recent literature. In basic and translational science, this summary includes the current state of genetics, epigenetics, differences by ancestry, and updates about the molecular and immunological pathogenesis of systemic lupus erythematosus. In clinical science, the summary includes updates in diagnosis and classification, clinical features and subphenotypes, and current guidelines and strategies for treatment. The paper also provides a comprehensive review of the large number of recent clinical trials in systemic lupus erythematosus. Current knowns and unknowns are presented, and potential directions for the future are suggested. Improved knowledge of immunological pathogenesis and the molecular differences that exist between patients should help to personalize treatment, minimize side effects, and achieve better outcomes in this difficult disease.

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