Prognosis of systemic lupus erythematosus and the factors that affect it.

The prognosis of systemic lupus erythematosus has improved over the past four decades. Articles published in the past year continue to demonstrate this improved survival, both overall and in patients with renal disease. Several factors may be associated with improved survival, including earlier diagnosis, better treatment for systemic lupus erythematosus, and improved medical therapy in general. Hydroxychloroquine has now clearly been shown to prevent flares, and ancrod has been shown to improve renal disease in patients with glomerular thrombosis. Treatment with dialysis and transplantation resulted not only in improved survival but also in improved renal status, and reduction in overall disease activity. Specific organ damage continues to be an issue, primarily with regard to kidney disease and neurocognitive impairment. The inclusion of health status assessment in the evaluation of patients with lupus, and as an outcome measure, is discussed.