Monash University, Melbourne, VIC
Monash University, Melbourne, VIC.
Med J Aust. 2017 Mar 20;206(5):215-220. doi: 10.5694/mja16.01229.
Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disease predominantly affecting women of childbearing age. New classification criteria for SLE have greater sensitivity and therefore improve the diagnostic certainty for some patients, especially those who may previously have been labelled as having undifferentiated symptoms. Uncontrolled disease activity leads to irreversible end-organ damage, which in turn increases the risk of premature death; early and sustained control of disease activity can usually be achieved by conventional immunosuppressant therapy. The development of biological therapy lags behind that for other rheumatic diseases, with belimumab being the only targeted therapy approved by the Therapeutic Goods Administration. "Treat-to-target" concepts are changing trial design and clinical practice, with evidence-based definition of response criteria in the form of remission and low disease activity now on the horizon. While new therapies are awaited, research should also focus on optimising the use of current therapy and improving the quality of care of patients with SLE.
系统性红斑狼疮（SLE）是一种慢性多系统自身免疫性疾病，主要影响育龄妇女。SLE 的新分类标准具有更高的敏感性，因此提高了某些患者的诊断确定性，尤其是那些以前可能被归类为具有未分化症状的患者。疾病活动未得到控制会导致不可逆转的靶器官损伤，进而增加过早死亡的风险；通过传统免疫抑制剂治疗通常可以早期和持续控制疾病活动。与其他风湿性疾病相比，生物治疗的发展较为滞后，贝利尤单抗是唯一获得治疗用品管理局批准的靶向治疗药物。“达标治疗”的概念正在改变试验设计和临床实践，目前正在制定基于缓解和低疾病活动度的有循证依据的反应标准。在等待新疗法的同时，还应关注优化现有治疗方法的使用，并提高 SLE 患者的护理质量。
