Neuropsychiatric Systemic Lupus Erythematosus Yoshiya Tanaka 1 1The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health Keyword: 全身性エリテマトーデス , 中枢神経系 , 神経精神ループス , 治療 , 生物学的製剤 , systemic lupus erythematosus , central nervous system , neuropsychiatric lupus , treatment , biological pp.1035-1048
Published Date 2016/9/1
DOI https://doi.org/10.11477/mf.1416200550
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Central nervous system damage, a major organ manifestation of systemic lupus erythematosus (SLE), causes significant morbidity and mortality. Designating this condition as neuropsychiatric SLE (NPSLE), the American College of Rheumatology defines it as involving the central and peripheral nervous systems and being characterized by various manifestations including stroke, seizures, and psychosis. NPSLE treatment mainly seeks to reduce damage accrual. In patients with NPSLE, the use of high-dose corticosteroids is recommended in combination with immunosuppressants, such as mycophenolate mofetil and intravenous cyclophosphamide pulse therapy. This can be accomplished by controlling the activity of the disease, minimizing the use of corticosteroids, and optimizing the management of comorbidities, including cardiovascular risk factors. An international task force analysis of a treat-to-target strategy for SLE (T2T/SLE) recommended targeting remission, preventing damage, and improving quality of life. Thus, more effective and less toxic treatments, such as those using biologics or kinase inhibitors, are still being developed for the treatment of SLE/NPSLE.

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