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”)

1. 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.
2. Disease recurrence should be prevented (especially severe relapse)
3. Treatment of patients without symptoms should not be intensified solely based on serological activity (in blood tests)
4. Organ damage indicates an increased risk of more injury and past death, which is essential to prevent
5. Exhaustion, pain and depression reduces quality of life and should be in focus when treating disease activity and prevention of injury
6. Attacks on kidneys is very important to detect early to start treatment without delay
7. After induction treatment of lupus nephritis is recommended at least three years subsequent immunosuppressive treatment
8. As among maintenance treatment at lupus, the lowest possible doses of glucocorticoids should be (Prednisone) sought. If possible, the corticosteroid treatment is completely discontinued provided the disease is under control
9. Prevention and treatment of SLE-related Antifosfolipid syndrome is a goal. The recommendation does not differ from that of primary antiphospholipid syndrome
10. Regardless of other treatment, one should consider supplementing with antimalarial drugs (Plaquenil)
11. Relevant adjunctive therapy to immunomodulatory therapy should be considered to control other concomitant diseases among SLE patients

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