Abstract
Zusammenfassung. Der systemische Lupus erythematodes ist eine Autoimmunerkrankung mit facettenreichem Organbefall. Hydroxychloroquin ist einer der wichtigsten Bestandteile der Therapie und soll, wenn immer möglich, eingesetzt werden. Belimumab ist eine inzwischen gut etablierte Add-on-Therapie in erster Linie zur Behandlung des Gelenk- und Hautbefalls sowie der Fatigue. Es wurde aber auch gezeigt, dass es die Schubrate sowie den Steroidgebrauch verringert. Eine weitere Therapiemöglichkeit mit dem Interferon Anifrolumab scheint sich aufzutun. Gesondert zu betrachten ist die Therapie bei Nierenbefall. Zur Induktions- und Erhaltungstherapie ist Mycophenolat-Mofetil gut etabliert.
Abstract. Systemic lupus erythematosus is a multisystem autoimmune disease. The mainstay of therapy are antimalarials, mostly hydroxychloroquine, which should be given whenever possible. Belimumab is in the meantime a well-established add-on treatment. In the first place, joint manifestations as well as skin and fatigue improve. It was also shown to reduce severe flares and steroid use. Another therapeutic option in the future might be the interferon anifrolumab due to positive results in new studies. In case of renal manifestations mycophenolate mofetil is widely used.
Résumé. Le lupus érythémateux systémique est une maladie auto-immune qui touche plusieurs organes. La hydroxychloroquine est l’un des composants les plus importants de la thérapie et doit être utilisée chaque fois que cela est possible. Le bélimumab est une thérapie complémentaire désormais bien établie pour le traitement primaire des infestations articulaires et cutanées et de la fatigue. Cependant, il a également été démontré qu’il réduit le taux de rechute et la consommation de stéroïdes. Une autre option thérapeutique avec l’interféron anifrolumab semble se dessiner. Le traitement des infections rénales doit être considéré séparément. Le mycophénolate mofétil est bien établi pour la thérapie d’induction et de maintien.
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