The use of glucocorticoids in systemic lupus erythematosus. After 60 years still more an art than science

Autoimmun Rev. 2013 Mar;12(5):617-28. doi: 10.1016/j.autrev.2012.12.001. Epub 2012 Dec 8.

Abstract

Systemic Lupus Erythematosus (SLE) is a clinically diverse, chronic autoimmune disease with inflammation in several organ systems. Its pathogenesis is complex, but includes many factors that can be influenced by glucocorticoids (GCs). Indeed, GCs constitute the corner-stone in SLE-treatment. However, guidelines for GC-treatment of the different disease manifestations are lacking and not every patient responds (sufficiently). The focus of this systematic review is to evaluate the differential glucocorticoid treatment of various SLE manifestations. In addition, some relevant mechanisms of glucocorticoid action as well as resistance are discussed.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adaptive Immunity / drug effects
  • Autoantibodies / biosynthesis
  • Autoantibodies / physiology
  • Autoantigens / immunology
  • Drug Tolerance / immunology
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / standards*
  • Glucocorticoids / therapeutic use*
  • Humans
  • Immunity, Cellular / drug effects
  • Immunity, Innate / drug effects
  • Lupus Erythematosus, Systemic / drug therapy*
  • Lupus Erythematosus, Systemic / etiology
  • Lupus Erythematosus, Systemic / pathology
  • Self Tolerance / drug effects

Substances

  • Autoantibodies
  • Autoantigens
  • Glucocorticoids