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Pharmacologic management of neuropsychiatric lupus

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Date
2016
Author
Kivity, Shaye
Baker, Britain
Arango, Maria-Teresa
Chapman, Joab
Shoenfeld, Yehuda
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Citation
URI
https://doi.org/10.1586/17512433.2016.1111137
https://repository.urosario.edu.co/handle/10336/24044

Abstract
Neuropsychiatric lupus affects above 50% of patients with systemic lupus erythematosus and may span from mild symptoms to acute devastating life-threatening ones. Owing to the clinical variability, most pharmacological data rely on small, uncontrolled trials and case reports. The mainstay of therapy relies on immune-suppression by glucocorticoids, in adjunction with cyclophosphamide or anti-B-cell therapy, in moderate to severe cases. In selected scenarios (e.g., chorea) intravenous immunoglobulin or plasmapheresis may be effective. Anticoagulation is warranted if anti-phospholipid antibodies are present. In parallel there may be a need for symptomatic treatment such as anti-epileptic or anti-depressive treatments, etc. In the future, more studies addressed to assess pathogenesis and preferred treatments of specific manifestations are needed in order to personalize treatments. © 2015 Taylor and Francis.

Keyword

Antimalarial agent ; central nervous system ; central nervous system ; systemic ; Azathioprine ; Belimumab ; Blood group b antibody ; Chloroquine ; Cyclophosphamide ; Glucocorticoid ; Hydroxychloroquine ; Immunoglobulin ; Methylprednisolone ; Methylprednisolone sodium succinate ; Mycophenolate mofetil ; Prednisone ; Rituximab ; Anticonvulsive agent ; Antidepressant agent ; Cyclophosphamide ; Glucocorticoid ; Immunosuppressive agent ; Anticoagulation ; Computer assisted tomography ; Human ; Immunosuppressive treatment ; Lupus erythematosus nephritis ; Lupus vulgaris ; Neuropsychiatric lupus ; Nuclear magnetic resonance imaging ; Nuclear magnetic resonance spectroscopy ; Palliative therapy ; Pharmaceutical care ; Phase 3 clinical trial (topic) ; Plasmapheresis ; Positron emission tomography ; Randomized controlled trial (topic) ; Review ; Single photon emission computer tomography ; Systematic review (topic) ; Systemic lupus erythematosus ; Animal ; B lymphocyte ; Complication ; Immunology ; Lupus vasculitis ; Pathophysiology ; Procedures ; Animals ; Anticonvulsants ; Antidepressive agents ; B-lymphocytes ; Cyclophosphamide ; Glucocorticoids ; Humans ; Immunosuppressive agents ; Lupus erythematosus ; Lupus vasculitis ; Plasmapheresis ; Anti-ribosomal p antibodies ; Cyclophosphamide ; Depression ; Neuropsychiatric lupus ; Systemic lupus erythematosus ;

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https://www.scopus.com/inward/record.uri?eid=2-s2.0-84949103666&doi=10.1586%2f17...

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