Treatment. Corticosteroids and anti-inflammatory drugs.

Nonsteroidal anti-inflammatory drugs and corticosteroids are important elements in the therapeutic armamentarium for patients with systemic lupus. The choice of NSAID needs to be individualized, but with optimal usage NSAIDs can often be used to manage symptoms previously treated with corticosteroids. For serious disease manifestations, corticosteroids are the cornerstone of therapy. Maximization of clinical response and avoidance of side effects continue to be important management goals. Different dosage regimens, such as intravenous methylprednisolone pulse therapy, and adjunctive agents, such as cyclophosphamide, are of continued interest in severe and potentially life-threatening disease. In addition, new nonsteroidal anti-inflammatory strategies including omega-3 series eicosanoids and new steroidal strategies including deflazacort and anti-glucocorticoids hold promise for continued improvement in the treatment on systemic lupus.