Systemischer Lupus erythematodes und Lupusnephritis: neue Therapiestrategien

ZUSAMMENFASSUNG

Der systemische Lupus erythematodes (SLE) ist eine Autoimmunerkrankung, welche nahezu jedes Organsystem befallen kann. Die Krankheitsmanifestationen sowie die Verläufe des SLE sind sehr heterogen, eine frühe Diagnosestellung und adäquate Therapie der meist jungen Patient*innen ist für die Langzeitprognose ausgesprochen relevant. Neben der klinischen Einschätzung können die im Jahr 2019 neu publizierten Klassifikationskriterien von EULAR/ACR (EULAR: European League Against Rheumatism; ACR: American College of Rheumatology) bei der Diagnosestellung unterstützend zur Hilfe genommen werden. Die Hauptursache für Morbidität und Mortalität der Patient*innen mit SLE ist die Entwicklung einer Lupusnephritis (LN), sodass hier eine frühe Diagnosestellung für die Prognose der Patient*innen unabdingbar ist. Im Mittelpunkt der Therapie steht das Erreichen einer vollständigen Remission bzw. zumindest das Erreichen einer niedrigen Krankheitsaktivität sowie das Vermeiden aktiver Krankheitsphasen, alles möglichst unter dem Verzicht des Einsatzes von Steroiden. Aufgrund der Heterogenität der Erkrankung sind häufig individualisierte Therapieanpassungen erforderlich. Neuere Erkenntnisse über die Pathomechanismen des SLE und der LN haben zur Entwicklung zielgerichteter Therapien („targeted therapies“) geführt, die zunehmend das Therapiespektrum für Patient*innen mit SLE erweitern.

Publication History

Article published online:
14 October 2022

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