Pharmacologic management of neuropsychiatric lupus

Neuropsychiatric lupus affects above 50% of patients with systemic lupus erythematosus and may span from mild symptoms to acute devastating life-threatening ones. Owing to the clinical variability, most pharmacological data rely on small, uncontrolled trials and case reports. The mainstay of therapy relies on immune-suppression by glucocorticoids, in adjunction with cyclophosphamide or anti-B-cell therapy, in moderate to severe cases. In selected scenarios (e.g., chorea) intravenous immunoglobulin or plasmapheresis may be effective. Anticoagulation is warranted if anti-phospholipid antibodies are present. In parallel there may be a need for symptomatic treatment such as anti-epileptic or anti-depressive treatments, etc. In the future, more studies addressed to assess pathogenesis and preferred treatments of specific manifestations are needed in order to personalize treatments. © 2015 Taylor and Francis.

• Fecha de publicación: 2016
• Institución: Universidad del Rosario
• Repositorio: Repositorio EdocUR - U. Rosario
• Idioma: eng
• OAI Identifier: oai:repository.urosario.edu.co:10336/24044
• Acceso en línea: https://doi.org/10.1586/17512433.2016.1111137; https://repository.urosario.edu.co/handle/10336/24044
• Palabra clave: Antimalarial agent; Azathioprine; Belimumab; Blood group b antibody; Chloroquine; Cyclophosphamide; Glucocorticoid; Hydroxychloroquine; Immunoglobulin; Methylprednisolone; Methylprednisolone sodium succinate; Mycophenolate mofetil; Prednisone; Rituximab; Anticonvulsive agent; Antidepressant agent; Cyclophosphamide; Glucocorticoid; Immunosuppressive agent; Anticoagulation; Computer assisted tomography; Human; Immunosuppressive treatment; Lupus erythematosus nephritis; Lupus vulgaris; Neuropsychiatric lupus; Nuclear magnetic resonance imaging; Nuclear magnetic resonance spectroscopy; Palliative therapy; Pharmaceutical care; Phase 3 clinical trial (topic); Plasmapheresis; Positron emission tomography; Randomized controlled trial (topic); Review; Single photon emission computer tomography; Systematic review (topic); Systemic lupus erythematosus; Animal; B lymphocyte; Complication; Immunology; Pathophysiology; Procedures; Animals; Anticonvulsants; Antidepressive agents; B-lymphocytes; Cyclophosphamide; Glucocorticoids; Humans; Immunosuppressive agents; Plasmapheresis; Anti-ribosomal p antibodies; Cyclophosphamide; Depression; Neuropsychiatric lupus; Systemic lupus erythematosus; central nervous system; central nervous system; systemic; Lupus vasculitis; Lupus erythematosus; Lupus vasculitis
• License: Abierto (Texto Completo)