Treatment in systemic lupus erythematosus (SLE).

Treatment in systemic lupus erythematosus (SLE) must be adjusted to the current level of disease activity and the course of the disease. The spectrum of established treatment principles ranges from no treatment or non-steroidal antirheumatic drugs alone, to glucocorticoids, hydroxychloroquine, azathioprine and, finally, cyclophosphamide (Ctx). Repeated pulses of intravenous Ctx can be regarded today as best established treatment for severe SLE. Administered in combination with prior plasmapheresis, pulse Ctx and subsequent peroral Ctx for 6 months have led to long-term treatment-free remission in some patients. Additional treatment options, whose potential benefits remain to be defined, are cyclosporine A, methotrexate, high-dose intravenous immunoglobulins and immunoadsorption. This review describes present knowledge regarding treatment in SLE and discusses the prospects for future development.