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10 most important contemporary challenges in the management of SLE
From a 1-year survival of less than 50% before the discovery of glucocorticoids to over 90% at 10 years in most dedicated centres, the spectrum of SLE has profoundly evolved. Despite this improvement, several major challenges currently remain. The aim of this review is to analyse what are, according...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6340557/ https://www.ncbi.nlm.nih.gov/pubmed/30729019 http://dx.doi.org/10.1136/lupus-2018-000303 |
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author | Felten, Renaud Sagez, Flora Gavand, Pierre-Edouard Martin, Thierry Korganow, Anne-Sophie Sordet, Christelle Javier, Rose-Marie Soulas-Sprauel, Pauline Rivière, Marianne Scher, Florence Poindron, Vincent Guffroy, Aurélien Arnaud, Laurent |
author_facet | Felten, Renaud Sagez, Flora Gavand, Pierre-Edouard Martin, Thierry Korganow, Anne-Sophie Sordet, Christelle Javier, Rose-Marie Soulas-Sprauel, Pauline Rivière, Marianne Scher, Florence Poindron, Vincent Guffroy, Aurélien Arnaud, Laurent |
author_sort | Felten, Renaud |
collection | PubMed |
description | From a 1-year survival of less than 50% before the discovery of glucocorticoids to over 90% at 10 years in most dedicated centres, the spectrum of SLE has profoundly evolved. Despite this improvement, several major challenges currently remain. The aim of this review is to analyse what are, according to us, the 10 most important contemporary challenges in the management of SLE. Among those are the need to treat to target to favour disease remission (or low disease activity), limit the use of glucocorticoids, derive more comprehensive tools for the evaluation of disease activity, develop more effective drugs (yielding successful trials), dissect the heterogeneity of the disease both at the molecular and genetic levels, identify relevant biomarkers for individualised treatment, manage fertility and pregnancy, tackle comorbidities such as cardiovascular risk, the prevention of infections and osteoporosis, improve the network of care (from the patients’ perspective), and favour a holistic approach (integrating fatigue, adherence to treatment, physical activity). Altogether, these 10 contemporary challenges in SLE may be considered as a roadmap for those involved in the daily care of patients with SLE, as well as for researchers who may wish to contribute to an improved management of this rare and complex disease. |
format | Online Article Text |
id | pubmed-6340557 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-63405572019-02-06 10 most important contemporary challenges in the management of SLE Felten, Renaud Sagez, Flora Gavand, Pierre-Edouard Martin, Thierry Korganow, Anne-Sophie Sordet, Christelle Javier, Rose-Marie Soulas-Sprauel, Pauline Rivière, Marianne Scher, Florence Poindron, Vincent Guffroy, Aurélien Arnaud, Laurent Lupus Sci Med Review From a 1-year survival of less than 50% before the discovery of glucocorticoids to over 90% at 10 years in most dedicated centres, the spectrum of SLE has profoundly evolved. Despite this improvement, several major challenges currently remain. The aim of this review is to analyse what are, according to us, the 10 most important contemporary challenges in the management of SLE. Among those are the need to treat to target to favour disease remission (or low disease activity), limit the use of glucocorticoids, derive more comprehensive tools for the evaluation of disease activity, develop more effective drugs (yielding successful trials), dissect the heterogeneity of the disease both at the molecular and genetic levels, identify relevant biomarkers for individualised treatment, manage fertility and pregnancy, tackle comorbidities such as cardiovascular risk, the prevention of infections and osteoporosis, improve the network of care (from the patients’ perspective), and favour a holistic approach (integrating fatigue, adherence to treatment, physical activity). Altogether, these 10 contemporary challenges in SLE may be considered as a roadmap for those involved in the daily care of patients with SLE, as well as for researchers who may wish to contribute to an improved management of this rare and complex disease. BMJ Publishing Group 2019-01-10 /pmc/articles/PMC6340557/ /pubmed/30729019 http://dx.doi.org/10.1136/lupus-2018-000303 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Review Felten, Renaud Sagez, Flora Gavand, Pierre-Edouard Martin, Thierry Korganow, Anne-Sophie Sordet, Christelle Javier, Rose-Marie Soulas-Sprauel, Pauline Rivière, Marianne Scher, Florence Poindron, Vincent Guffroy, Aurélien Arnaud, Laurent 10 most important contemporary challenges in the management of SLE |
title | 10 most important contemporary challenges in the management of SLE |
title_full | 10 most important contemporary challenges in the management of SLE |
title_fullStr | 10 most important contemporary challenges in the management of SLE |
title_full_unstemmed | 10 most important contemporary challenges in the management of SLE |
title_short | 10 most important contemporary challenges in the management of SLE |
title_sort | 10 most important contemporary challenges in the management of sle |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6340557/ https://www.ncbi.nlm.nih.gov/pubmed/30729019 http://dx.doi.org/10.1136/lupus-2018-000303 |
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