
Treat to target in Lupus. Illustration: Pxhere CC0
Treatment goals at Lupus / SLE (EULAR recommendations 2014)
At the start of treatment, the doctor and the patient should set goals that are to be achieved with the treatment within a specific time limit (“Treat_to_target”)
- Treatment goals by Systemic lupus (SLE) should be remission of systemic symptoms and organ manifestations. If remission cannot be achieved, the lowest possible disease activity is measured by a validated lupus activity index and / or by organ-specific markers.
- Disease recurrence should be prevented (especially severe relapse)
- Treatment of patients without symptoms should not be intensified solely based on serological activity (in blood tests)
- Organ damage indicates an increased risk of more injury and earlier death, which is essential to prevent
- Exhaustion, pain and depression reduces quality of life and should be in focus when treating disease activity and prevention of injury
- Attacks on kidneys is very important to detect early to start treatment without delay
- After induction treatment of lupus nephritis is recommended at least three years subsequent immunosuppressive treatment
- Audio maintenance treatment in lupus should be the lowest possible dose of glucocorticoid (Prednisone) sought. If possible, the corticosteroid treatment is completely discontinued provided the disease is under control
- Prevention and treatment of SLE-related Antifosfolipid syndrome is a goal. The recommendation does not differ from that of primary antiphospholipid syndrome
- Regardless of other treatment, one should consider supplementing with antimalarial drugs (Plaquenil)
- Relevant adjunctive therapy to immunomodulatory therapy should be considered to control other concomitant diseases among SLE patients
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