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KMID : 1134220120320020083
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Hanyang Medical Reviews
2012 Volume.32 No. 2 p.83 ~ p.93
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Novel Pharmacologic Therapies in the Treatment of Systemic Lupus Erythematosus
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Shim Seung-Cheol
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Abstract
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Systemic lupus erythematosus (lupus) is an autoimmune disease that affects primarily women, especially those of reproductive age. Lupus is a prototypic organ non-specific autoimmune disease that may affect any organ in the body resulting in displaying a broad spectrum of clinical and immunological manifestations. The pathogenesis of lupus involves a complex interplay between genetic and environmental factors and the adaptive and innate immune systems. Defects in central and peripheral tolerance, increased antigenic load, excess T-cell help, B cell hyperactivity, autoantibody production and cytokine imbalance, ultimately lead to immune-complex formation and complement activation causing immunologically mediated organ damage, culminating in premature death. There is an urgent need for the development of novel agents since many patients are refractory to traditional agents. However, there are two hurdles that make development of new therapeutic agents difficult. First, we do not understand the whole picture of the pathogenesis of lupus because of its complex and multi-systemic presentation. Secondly, lupus lacks a reliable and sensitive biomarker for measuring disease activity, and a standardized method for defining response to therapy. Nevertheless, great advances have been made during the past 10 years because of the great efforts of basic researchers and clinicians on elucidating the cause of the disease, and participation of pharmaceutical and biotechnical companies in the development of novel agents. My goal was to evaluate the efficacy and safety of novel pharmaceutical agents by a comprehensive review of open-label and randomized clinical trials conducted in patients with lupus.
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KEYWORD
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Lupus Erythematosus, Systemic, Pharmaceutical Services, Biological Agents
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