RT Book, Section
A1 Resman-Targoff, Beth H.
A2 DiPiro, Joseph T.
A2 Yee, Gary C.
A2 Posey, L. Michael
A2 Haines, Stuart T.
A2 Nolin, Thomas D.
A2 Ellingrod, Vicki
SR Print(0)
ID 1182449635
T1 Systemic Lupus Erythematosus
T2 Pharmacotherapy: A Pathophysiologic Approach, 11e
YR 2020
FD 2020
PB McGraw-Hill Education
PP New York, NY
SN 9781260116816
LK accesspharmacy.mhmedical.com/content.aspx?aid=1182449635
RD 2024/04/20
AB KEY  CONCEPTS  Systemic  lupus  erythematosus  (SLE)  is  considered  a  disease  primarily  of  young  women,  but  it  can  occur  in  anyone.  The  prevalence  and  severity  vary  with  sex,  race,  ethnicity,  and  socioeconomic  factors.  Understanding  the  etiology  of  SLE  and  environmental  factors  that  can  initiate  or  exacerbate  the  disease  may  make  it  possible  to  avoid  those  triggers.  SLE  is  an  autoimmune  disease  characterized  by  the  presence  of  autoantibodies,  some  of  which  may  play  a  role  in  the  pathogenesis  of  the  disease.  An  understanding  of  disease  mechanisms  can  lead  to  targeted  drug  therapy.  SLE  is  a  multisystem  disease  that  can  involve  almost  any  organ  and  may  present  in  many  different  ways.  Therapy  is  determined  by  the  manifestations  in  each  patient,  which  may  change  and  fluctuate  in  severity  over  time.  Lifestyle  changes  can  modify  risk  factors  for  SLE  flares  and  complications.  The  overall  goals  of  therapy  are  to  prevent  disease  flares  and  involvement  of  other  organs,  decrease  disease  activity  and  prevent  damage,  achieve  and  maintain  remission,  reduce  use  of  corticosteroids,  and  improve  quality  of  life,  while  minimizing  adverse  effects  and  costs.  Most  patients  with  SLE  should  receive  hydroxychloroquine  alone  or  in  combination  with  other  therapy  appropriate  for  the  disease  manifestations.  Pregnancy  planning  is  essential  for  good  outcomes.  Pregnancy  outcomes  are  best  when  the  disease  is  controlled  before  conception.  Drugs  used  to  treat  SLE  may  adversely  affect  fertility  and  the  fetus.  Antiphospholipid  antibodies  are  associated  with  arterial  and  venous  thrombosis  and  obstetric  complications.  Many  drugs  can  induce  a  lupus-like  syndrome.  The  manifestations  and  laboratory  findings  may  be  different  between  the  traditional  drug-induced  lupus  and  that  seen  with  use  of  tumor  necrosis  factor-alpha  inhibitors.  Since  SLE  can  present  in  many  different  ways,  it  is  difficult  to  design  standard  response  criteria.  Development  of  appropriate  criteria  is  essential  for  the  approval  of  new  drugs.