REVIEW - Why can't we find a new treatment for SLE?

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J Autoimmun. 2009 May-Jun;32(3-4):223-30. Epub 2009 Mar 28.

Why can't we find a new treatment for SLE?

Eisenberg R.

Division of Rheumatology, Department of Medicine, 756 BRBII/III, 421

Curie Blvd, University of Pennsylvania, Philadelphia, PA 19104-6160,

USA.

No new therapy for systemic lupus erythematosus has been approved. In

the last decade, the development of several novel compounds has been

pursued for lupus, but so far nothing has been proven to be effective.

This review discusses some of the reasons why it may be so difficult

to demonstrate that a novel therapy is effective for this disease.

These include the complexity of the disease itself; the lack of

reliable outcome measures; our limited understanding of the

pathogenesis of the disease; the propensity of lupus patients to have

bad outcomes and to react to medicines in unusual ways; the

heterogeneity of the patient population; the unpredictable course of

disease in individual patients; and the lack of reliable biomarkers.

Although some of the tested targeted compounds that are apparently

based on strong preclinical and mechanistic data may indeed not be

effective therapies for SLE, it is hard not to believe that among the

various specific agents now being tested that at least some of them

should downregulate the abnormal immunoregulation characteristic of

SLE, and thus be clinically effective. We need to be persistent and

imaginative in identifying these effective agents and proving their

efficacy so that they may be widely used in our lupus populations.

PMID: 19329279

http://www.ncbi.nlm.nih.gov/pubmed/19329279

Not an MD