Current challenges in the management of systemic lupus erythematosus

During the 38th Annual Conference of Indian Rheumatology Association (IRACON) 2023, the Lupus Hub was pleased to speak with Laurent Arnaud, Strasbourg University School of Medicine, Strasbourg, FR. We asked about the current challenges in the management of systemic lupus erythematosus (SLE).

Arnaud begins by addressing damage accrual in patients with SLE resulting from uncontrolled disease activity and treatment side effects, particularly due to corticosteroids. He explores the concept of treat-to-target and disease modification, emphasizing the need for early intervention. Arnaud emphasizes achieving the definition of remission in SLE (DORIS) and having a plan B for attaining Lupus Low Disease Activity State (LLDAS). Acknowledging substantial drug trial failures, he mentions 92 drugs currently under development, with more than 15 in phase II, and expresses hope for their success. While more data are warranted to support the early use of biologics, he advises optimizing existing treatments with hydroxychloroquine, immunosuppressants, and prudent corticosteroid use.