Who manages Systemic Lupus Erythematosus (SLE)?

From the Guidelines

Systemic Lupus Erythematosus (SLE) is typically managed by a rheumatologist, a specialist in autoimmune diseases, who coordinates care with other healthcare providers as needed, including primary care physicians, dermatologists, and nephrologists. The management of SLE involves a multidisciplinary approach, based on a shared patient-physician decision, and should consider individual, medical, and societal costs 1.

Treatment Approach

The treatment goals for SLE include long-term patient survival, prevention of organ damage, and optimization of health-related quality of life 1. Treatment usually involves hydroxychloroquine as a first-line medication to control inflammation and prevent flares, with a recommended dose not exceeding 5 mg/kg real body weight 1. For more severe disease, corticosteroids like prednisone may be used, with the aim of minimizing the dose to less than 7.5 mg/day (prednisone equivalent) and, when possible, withdrawing them 1.

Medication Management

Immunosuppressants such as methotrexate, azathioprine, or mycophenolate mofetil are added for organ involvement, and belimumab, a biologic medication, may be prescribed for active disease not responding to standard therapies 1. The treatment approach should be comprehensive, including sun protection, regular exercise, stress management, and a balanced diet. Regular monitoring of blood work, kidney function, and other affected organs is essential as lupus is a chronic condition requiring ongoing management to prevent flares and organ damage.

Key Considerations

Some key considerations in the management of SLE include:

• Assessing patients for their antiphospholipid antibody status, infectious and cardiovascular diseases risk profile, and tailoring preventative strategies accordingly 1.
• Providing updated consensus guidance on the management of SLE, combining evidence-base and expert-opinion 1.
• Considering the individual, medical, and societal costs in the management of SLE 1.

From the FDA Drug Label

What is BENLYSTA • BENLYSTA is a prescription medicine used to treat: ○ adults and children 5 years of age and older with active systemic lupus erythematosus (SLE or lupus) who are receiving other lupus medicines,

The management of Systemic Lupus Erythematosus (SLE) typically involves a healthcare provider, as BENLYSTA is a prescription medicine used to treat adults and children with active SLE who are receiving other lupus medicines 2.

From the Research

Management of Systemic Lupus Erythematosus (SLE)

• SLE is a complex autoimmune disease that can affect multiple organ systems, requiring a multidisciplinary approach to management 3, 4, 5.
• Rheumatologists, nephrologists, and other specialists are involved in the management of SLE, and collaboration between these specialists is essential for optimal care 3, 4, 5.
• The management of SLE may involve a range of healthcare professionals, including:
  • Rheumatologists: specialize in the diagnosis and treatment of rheumatic diseases, including SLE 3, 4, 5.
  • Nephrologists: specialize in the diagnosis and treatment of kidney diseases, including lupus nephritis 3, 5, 6.
  • Immunologists: specialize in the diagnosis and treatment of immune system disorders, including SLE 5.
  • Primary care physicians: may be involved in the initial diagnosis and management of SLE, and may refer patients to specialists as needed 4.
• A multidisciplinary approach to management is recommended, with specialists working together to develop a comprehensive treatment plan 3, 5, 6.

Treatment and Management

• The treatment of SLE typically involves a combination of medications, including:
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) 7.
  • Immunosuppressive drugs, such as corticosteroids and cyclophosphamide 3, 7, 6.
  • Biological agents, such as belimumab 3, 7, 6.
• The management of SLE also involves lifestyle modifications, such as:
  • Avoiding triggers that can exacerbate symptoms 4.
  • Getting regular exercise and maintaining a healthy diet 4.
• Regular monitoring and follow-up with healthcare professionals is essential to manage the disease and prevent complications 4, 5, 6.

Coordination of Care

• Coordination of care between healthcare professionals is essential to ensure that patients receive comprehensive and consistent care 4, 5.
• Rheumatologists and other specialists should work closely with primary care physicians to develop a comprehensive treatment plan and ensure that patients receive regular follow-up care 4, 5.
• Patients should be educated about their disease and involved in the decision-making process to ensure that they receive care that meets their needs and preferences 4, 5.