Therapy of systemic lupus erythematosus: a look into the future

This manuscript is dedicated to Professor Tiny Maini in admiration of his grand mind and great work, in thankful appreciation of the numerous hours of our scientific debates, discussions on the future of rheumatology, and great personal enjoyment over the past 15 years, and with sincere gratitude for his support, guidance, and friendship over so many years. CHAPTER SUMMARY: The prognosis for patients with systemic lupus erythematosus has greatly improved over the past two decades. However, therapies that are more effective and that have fewer sequelae are needed to rescue patients from organ failure and further reduce mortality. Research under way, including that into induction of tolerance to self-antigens, prevention of the consequences of pathogenic autoantibody production, interference with the cytokine network and signal transduction, the identification and treatment of any infectious triggers, and stem cell therapy, offers hope of improved remedies or even of cure. Given the fact that a number of biological therapies for rheumatologic disease are already in use or are in the development stage, such progress may come soon.