Advances and prospects in the treatment of systemic lupus erythematosus

AIM: To reveal the priorities of Russian rheumatology to develop treatment options for systemic lupus erythematosus (SLE). MATERIALS AND METHODS: The data available in the Russian and foreign literature, the archives and publications by the researchers of the Institute of Rheumatology on systemic lupus erythematosus in 1958 to 2008 were analyzed. RESULTS: Analyzing the literature references has ascertained that the researchers of the Institute of Rheumatology, Russian Academy of Medical Sciences, have initiated studies to develop therapy methods for SLE since 1958. Diagnostic criteria for and SLE course type definitions and classification have been first developed in Russian and foreign medicine; the principles of optimal glucocorticoid, cytostatic therapy, and follow-up of patients with SLE have been proposed on the basis of a long-term observation. In Russian medicine, the Institute's researchers have first developed an algorithm of therapy for lupus nephritis, by using plasmapheresis, pulse therapy with methylprednisolone and cyclophosphan, and suppressing and maintaining doses of glucocorticoids. The practical application of the SLE treatment methods developed at the Institute have reduced mortality and increased 10-year survival in patients with SLE up to 90%. The Institute of Rheumatology has first provided data on the efficiency of anti-B-cell therapy for SLE in Russian rheumatology. CONCLUSION: Prognosis in patients with SLE has substantially changed in the past 50 years. The Russian rheumatologists have studied the clinical manifestations of the disease in detail; its diagnosis has improved; the specific features of SLE have been revealed; the treatment methods adequate to the clinical manifestations of the disease have been developed. Multicomponent therapy for SLE, monitoring, and follow-ups have solved the problem of curing SLE.