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Optimizing pharmacotherapy of systemic lupus erythematosus: the pharmacist role

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Abstract

Background Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that can affect any part of the body. The management of the disease includes nonpharmacotherapy and pharmacotherapy. Aim of the review To provide an up-to-date review of the etiology, epidemiology, clinical features, diagnostic findings, and treatment options for SLE. Methods Data source: A PubMed search of English language journals using a combination of words—elderly, SLE, late onset SLE, etiology, screening, diagnosis, or treatment to identify original studies, guidelines, and reviews on SLE, SLE, late onset SLE published between 2000 and present. Overall, original studies, clinical reviews, references, and guidelines were obtained and evaluated on their clinical relevance. The literature included guidelines and considerations for the etiology, diagnosis, screening, and management of SLE, late onset SLE. Results SLE is a chronic autoimmune disorder, the exact etiology of which is unknown. SLE predominately affects younger women; however, it is reported to occur in up to 20 % of patients 50 years or older. In patients with SLE, nearly every system in the body is affected with varying degrees of severity ranging from subclinical to fatal. The hallmark feature of SLE is the production of autoantibodies directed primarily against nuclear antigens, but also against cytoplasmic components of cells. Conclusion The diagnosis of SLE is based on criteria set by the American College of Rheumatology. Management is individualized and depends on presenting symptoms and reducing the likelihood of permanent damage to organs and tissues.

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Abbreviations

ALT:

Alanine transaminase

ACR:

American College of Rheumatology

ACEIs:

Angiotensin converting enzyme inhibitors

Anti-DNA:

Anti-deoxyribonucleic acid

Anti-dsDNA:

Anti-doublestranded deoxyribonucleic acid

Anti-La/SS-B:

Anti-La Sjorgren syndrome type B

Anti-Ro/SS-B:

Anti-Ro/Sjorgren syndrome type B

ANA:

Antinuclear antibodies

Anti-RNP:

Anti ribonucleoprotein

Anti-Sm:

Anti-Smith antibodies

AST:

Aspartate transaminase

CBC:

Complete blood count

COX-1:

Cyclooxygenase-1

COX-2:

Cyclooxygenase-2

EULAR:

European league against rheumatism

MTX:

Methotrexate

NSAIDs:

Non-steroidal anti-inflammatory drugs

SLE:

Systemic lupus erythematosus

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Conflicts of interest

All authors stated that there is no conflict of interest in this study.

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Authors and Affiliations

  1. Department of Pharmaceutical Sciences, College of Health Sciences, Public Authority for Applied Education and Training (PAAET), Kuwait, Kuwait

    Maryam Al Hussaini

  2. Pharmacy Department, Tawam Hospital in Affiliation with John Hopkins Medicine, Al Ain, United Arab Emirates

    Emad I. Hammouda

  3. Faculty of Pharmacy, German University of Cairo, Cairo, Egypt

    Ahmed E. Hammouda

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  1. Maryam Al Hussaini
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  2. Emad I. Hammouda
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  3. Ahmed E. Hammouda
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Correspondence to Maryam Al Hussaini.

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Al Hussaini, M., Hammouda, E.I. & Hammouda, A.E. Optimizing pharmacotherapy of systemic lupus erythematosus: the pharmacist role. Int J Clin Pharm 36, 684–692 (2014). https://doi.org/10.1007/s11096-014-9966-1

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