Gödecke Vega, Witte Torsten
Klinik für Nieren- und Hochdruckerkrankungen, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625, Hannover, Deutschland.
Klinik für Rheumatologie und Immunologie, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625, Hannover, Deutschland.
Z Rheumatol. 2024 Aug;83(6):439-446. doi: 10.1007/s00393-024-01551-6.
Systemic lupus erythematosus (SLE) is an autoimmune disease with variable clinical presentation and organ involvement. Early diagnosis and rapid achievement of low disease activity or remission reduces organ damage and improves prognosis. Therapeutic principles can be divided into so-called basic measures and immunosuppressive treatment. Novel drugs have been developed in recent years, with new classes of agents being added for the treatment of SLE. These include biologic therapies and approved therapeutic options for the treatment of lupus nephritis. In light of improved treatment options, good disease control can now frequently be achieved; with savings on glucocorticoids, combination therapies are increasingly being used. Of great importance is the consistent use of basic measures, which include the use of hydroxychloroquine, optimization of cardiovascular risk factors, UV protection, bone-protective measures, and the implementation of vaccinations. In the treatment of lupus nephritis, conservative therapeutic measures for nephroprotection play a crucial role in renal prognosis. Finally, non-pharmacological therapy options such as exercise therapy are of great importance for improving quality of life.
系统性红斑狼疮（SLE）是一种临床表现多样且累及多器官的自身免疫性疾病。早期诊断并迅速实现低疾病活动度或缓解可减少器官损害并改善预后。治疗原则可分为所谓的基本措施和免疫抑制治疗。近年来已研发出新型药物，治疗SLE的新型药物类别不断增加。这些药物包括生物疗法以及获批用于治疗狼疮性肾炎的治疗方案。鉴于治疗选择的改善，目前常常能够实现良好的疾病控制；随着糖皮质激素用量的减少，联合疗法的应用越来越广泛。持续采用基本措施非常重要，这些措施包括使用羟氯喹、优化心血管危险因素、紫外线防护、骨骼保护措施以及接种疫苗。在狼疮性肾炎的治疗中，肾脏保护的保守治疗措施对肾脏预后起着至关重要的作用。最后，运动疗法等非药物治疗选择对于提高生活质量非常重要。
