New therapies for systemic lupus erythematosus: has the future arrived?

Systemic lupus erythematosus (SLE) is an autoimmune disorder characterized by defects in many parts of the immune cascade. Current therapies can be criticized for being too wide-ranging in their actions, but newer biological therapies described in this article might, in the future, enhance efficacy and reduce toxicity by targeting specific aspects of B-cell, T-cell and cytokine function. Some evidence for these newer agents is encouraging but unwanted and unexpected effects have been encountered suggesting their usefulness might be questioned. While minimizing unwanted effects and maximizing the effectiveness of treatment is the current aim of therapy, permanent remission or cure must be the gold standard aim in the future. The extent to which we are approaching this exciting objective is reviewed in this article.