PDF herunterladen
Dtsch Med Wochenschr 2016; 141(08): 537-543
DOI: 10.1055/s-0041-110604
Dossier
Kollagenosen
© Georg Thieme Verlag KG Stuttgart · New York

Systemischer Lupus erythematodes

Systemic lupus erythematosus
Martin Aringer
1   Rheumatologie, Klinik und Poliklinik für Innere Medizin III, Universitätsklinikum Carl Gustav Carus an der TU Dresden
,
Matthias Schneider
2   Poliklinik und Funktionsbereich für Rheumatologie und Hiller-Forschungszentrum Rheumatologie, Universitätsklinikum Düsseldorf
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
29. März 2016 (online)

Auch verfügbar auf
   Lizenzen und Reprints

Zusammenfassung

Die Betreuung von Patientinnen und Patienten mit SLE stellt nach wie vor eine auch intellektuelle Herausforderung dar. Für die meisten Standardsituationen lassen sich aber klare Grundsätze der Abklärung und Therapie herausarbeiten. Neue Medikamente und internationale erarbeitete Festlegungen der Behandlungsstrategien stellen signifikante Verbesserungen dar und versprechen auch für die kommenden Jahre weiteren Fortschritt.

Abstract

The management of patients with SLE still brings significant challenges, also on intellectual grounds. However, for most of the standard situations, clear principles can be delineated for diagnosis and therapy. New drugs and international definitions of strategies in SLE patient care constitute significant improvement and promise further progress for the coming years.

Schlüsselwörter

Lupus - Autoantikörper - Hydroxychloroquin - Nephritis - kardiovaskuläres Risiko

Keywords

lupus - autoantibodies - hydroxychloroquine - nephritis - cardiovascular risk
 

  • Literatur

  • 1 Rahman A, Isenberg DA. Systemic lupus erythematosus. N Engl J Med 2008; 358: 929-939
    CrossrefPubMedSuche in Google Scholar
  • 2 Sokos GC. Systemic lupus erythematosus. N Engl J Med 2011; 365: 2110-2121
    CrossrefPubMedSuche in Google Scholar
  • 3 Tan EM, Cohen AS, Fries JF et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1982; 25: 1271-1277
    CrossrefPubMedSuche in Google Scholar
  • 4 Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1997; 40: 1725
    PubMedSuche in Google Scholar
  • 5 Petri M, Orbai AM, Alarcon GS et al. Derivation and validation of systemic lupus international collaborating clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum 2012; 64: 2677-2686
    CrossrefPubMedSuche in Google Scholar
  • 6 Bertsias GK, Tektonidou M, Amoura Z et al. Joint European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association (EULAR / ERA-EDTA) recommendations for the management of adult and paediatric lupus nephritis. Ann Rheum Dis 2012; 71: 1771-1782
    CrossrefPubMedSuche in Google Scholar
  • 7 Aringer M, Schneider M. Kochrezepte Systemischer Lupus erythematodes. Z Rheumatol 2014; 73: 496-500
    CrossrefPubMedSuche in Google Scholar
  • 8 van Vollenhoven RF, Mosca M, Bertsias G et al. Treat-to-target in systemic lupus erythematosus: recommendations from an international task force. Ann Rheum Dis 2014; 73: 958-967
    CrossrefPubMedSuche in Google Scholar
  • 9 Mosca M, Tani C, Aringer M et al. European League Against Rheumatism recommendations for monitoring patients with systemic lupus erythematosus in clinical practice and in observational studies. Ann Rheum Dis 2010; 69: 1269-1274
    CrossrefPubMedSuche in Google Scholar
  • 10 Dall’Era M, Cisternas MG, Smilek DE et al. Predictors of long-term renal outcome in lupus nephritis trials: lessons learned from the Euro-Lupus Nephritis cohort. Arthritis Rheumatol 2015; 67: 1305-1313
    CrossrefPubMedSuche in Google Scholar
  • 11 Condon MB, Ashby D, Pepper RJ et al. Prospective observational single-centre cohort study to evaluate the effectiveness of treating lupus nephritis with rituximab and mycophenolate mofetil but no oral steroids. Ann Rheum Dis 2013; 72: 1280-1286
    CrossrefPubMedSuche in Google Scholar
  • 12 Fischer-Betz R, Chehab G, Sander O et al. Renal outcome in patients with lupus nephritis using a steroid-free regimen of monthly intravenous cyclophosphamide: a prospective observational study. J Rheumatol 2012; 39: 2111-2117
    CrossrefPubMedSuche in Google Scholar
  • 13 Bertsias G, Ioannidis JP, Boletis J et al. EULAR recommendations for the management of systemic lupus erythematosus. Report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics. Ann Rheum Dis 2008; 67: 195-205
    PubMedSuche in Google Scholar
  • 14 Fischer-Betz R. Rheumatische Erkrankungen in der Schwangerschaft. Dtsch Med Wochenschr 2013; 138: 1589-1591
    Thieme ConnectPubMedSuche in Google Scholar
  • 15 Winzer M, Aringer M. Use of methotrexate in patients with systemic lupus erythematosus and primary Sjogren’s syndrome. Clin Exp Rheumatol 2010; 28: S156-S159
    PubMedSuche in Google Scholar
  • 16 Navarra SV, Guzman RM, Gallacher AE et al. Efficacy and safety of belimumab in patients with active systemic lupus erythematosus: a randomised, placebo-controlled, phase 3 trial. Lancet 2011; 377: 721-731
    CrossrefPubMedSuche in Google Scholar
  • 17 Furie R, Petri M, Zamani O et al. A phase III, randomized, placebo-controlled study of belimumab, a monoclonal antibody that inhibits B lymphocyte stimulator, in patients with systemic lupus erythematosus. Arthritis Rheum 2011; 63: 3918-3930
    CrossrefPubMedSuche in Google Scholar
  • 18 Fischer-Betz R, Schneider M. Empfehlungen zum Einsatz von Belimumab beim systemischen Lupus erythematodes. Z Rheumatol 2013; 72: 462-467
    CrossrefPubMedSuche in Google Scholar
  • 19 van Vollenhoven RF, Petri MA, Cervera R et al. Belimumab in the treatment of systemic lupus erythematosus: high disease activity predictors of response. Ann Rheum Dis 2012; 71: 1343-1349
    CrossrefPubMedSuche in Google Scholar
  • 20 Steinberg AD, Steinberg SC. Long-term preservation of renal function in patients with lupus nephritis receiving treatment that includes cyclophosphamide versus those treated with prednisone only. Arthritis Rheum 1991; 34: 945-950
    CrossrefPubMedSuche in Google Scholar
  • 21 Houssiau FA, Vasconcelos C, D‘Cruz D et al. The 10-year follow-up data of the Euro-Lupus Nephritis Trial comparing low-dose and high-dose intravenous cyclophosphamide. Ann Rheum Dis 2010; 69: 61-64
    CrossrefPubMedSuche in Google Scholar
  • 22 Houssiau FA, D‘Cruz D, Sangle S et al. Azathioprine versus mycophenolate mofetil for long-term immunosuppression in lupus nephritis: results from the MAINTAIN Nephritis Trial. Ann Rheum Dis 2010; 69: 2083-2089
    CrossrefPubMedSuche in Google Scholar
  • 23 Wofsy D, Diamond B, Houssiau FA. Crossing the Atlantic: the Euro-Lupus Nephritis regimen in North America. Arthritis Rheumatol 2015; 67: 1144-1146
    CrossrefPubMedSuche in Google Scholar
  • 24 ACCESS Trial Group. Treatment of lupus nephritis with abatacept: the Abatacept and Cyclophosphamide Combination Efficacy and Safety Study. Arthritis Rheumatol 2014; 66: 3096-3104
    CrossrefPubMedSuche in Google Scholar
  • 25 Austin III HA, Illei GG, Braun MJ. Randomized, controlled trial of prednisone, cyclophosphamide, and cyclosporine in lupus membranous nephropathy. J Am Soc Nephrol 2009; 20: 901-911
    CrossrefPubMedSuche in Google Scholar
  • 26 Appel GB, Contreras G, Dooley MA et al. Mycophenolate mofetil versus cyclophosphamide for induction treatment of lupus nephritis. J Am Soc Nephrol 2009; 20: 1103-1112
    CrossrefPubMedSuche in Google Scholar
  • 27 Ginzler EM, Dooley MA, Aranow C et al. Mycophenolate mofetil or intravenous cyclophosphamide for lupus nephritis. N Engl J Med 2005; 353: 2219-2228
    CrossrefPubMedSuche in Google Scholar
  • 28 Dooley MA, Jayne D, Ginzler EM et al. Mycophenolate versus azathioprine as maintenance therapy for lupus nephritis. N Engl J Med 2011; 365: 1886-1895
    CrossrefPubMedSuche in Google Scholar
  • 29 Ginzler EM, Wofsy D, Isenberg D et al. Nonrenal disease activity following mycophenolate mofetil or intravenous cyclophosphamide as induction treatment for lupus nephritis: findings in a multicenter, prospective, randomized, open-label, parallel-group clinical trial. Arthritis Rheum 2010; 62: 211-221
    CrossrefPubMedSuche in Google Scholar
  • 30 Aringer M, Fischer-Betz R, Hiepe F. Stellungnahme zum Einsatz von Mycophenolat-Mofetil beim systemischen Lupus erythematodes. Z Rheumatol 2013; 72: 575-580
    CrossrefPubMedSuche in Google Scholar
  • 31 Merrill JT, Neuwelt CM, Wallace DJ et al. Efficacy and safety of rituximab in moderately-to-severely active systemic lupus erythematosus: the randomized, double-blind, phase II / III systemic lupus erythematosus evaluation of rituximab trial. Arthritis Rheum 2010; 62: 222-233
    CrossrefPubMedSuche in Google Scholar
  • 32 Rovin BH, Furie R, Latinis K et al. Efficacy and safety of rituximab in patients with active proliferative lupus nephritis: The lupus nephritis assessment with rituximab (LUNAR) study. Arthritis Rheum 2012; 64: 1215-1226
    CrossrefPubMedSuche in Google Scholar
  • 33 Aringer M, Burkhardt H, Burmester GR et al. Current state of evidence on ‚off-label‘ therapeutic options for systemic lupus erythematosus, including biological immunosuppressive agents, in Germany, Austria and Switzerland--a consensus report. Lupus 2012; 21: 386-401
    CrossrefPubMedSuche in Google Scholar
  • 34 Stummvoll GH, Julius U, Derfler K et al. Immunoadsorption for systemic lupus erythematosus. Atheroscler Suppl 2009; 10: 110-113
    CrossrefPubMedSuche in Google Scholar
  • 35 Alexander T, Thiel A, Rosen O et al. Depletion of autoreactive immunologic memory followed by autologous hematopoietic stem cell transplantation in patients with refractory SLE induces long-term remission through de novo generation of a juvenile and tolerant immune system. Blood 2009; 113: 214-223
    CrossrefPubMedSuche in Google Scholar
  • 36 Illei GG, Shirota Y, Yarboro CH, Daruwalla J, Tackey E, Takada K et al. Tocilizumab in systemic lupus erythematosus: Data on safety, preliminary efficacy, and impact on circulating plasma cells from an open-label phase I dosage-escalation study. Arthritis Rheum 2010; 62: 542-552
    CrossrefPubMedSuche in Google Scholar
  • 37 Pena-Rossi C, Nasonov E, Stanislav M et al. An exploratory dose-escalating study investigating the safety, tolerability, pharmacokinetics and pharmacodynamics of intravenous atacicept in patients with systemic lupus erythematosus. Lupus 2009; 18: 547-555
    CrossrefPubMedSuche in Google Scholar
  • 38 Alexander T, Sarfert R, Klotsche J et al. The proteasome inhibitior bortezomib depletes plasma cells and ameliorates clinical manifestations of refractory systemic lupus erythematosus. Ann Rheum Dis 2015; 74: 1474-1478
    CrossrefPubMedSuche in Google Scholar
  • 39 Khamashta MA, Bertolaccini ML, Hughes GR. Antiphospholipid (Hughes) syndrome. Autoimmunity 2004; 37: 309-312
    CrossrefPubMedSuche in Google Scholar
  • 40 Ruiz-Irastorza G, Cuadrado MJ, Ruiz-Arruza I et al. Evidence-based recommendations for the prevention and long-term management of thrombosis in antiphospholipid antibody-positive patients: report of a task force at the 13th International Congress on antiphospholipid antibodies. Lupus 2011; 20: 206-218
    CrossrefPubMedSuche in Google Scholar