Therapy with biologic agents in SLE

The revolution of biologic targeted therapy for autoimmune disease is underway. While anticytokine treatment (anti-TNF-α and anti-IL-1Ra) are proving beneficial in such diseases as rheumatoid arthritis and spondyloarthropathies, the road to successful treatment in systemic lupus erythematosus (SLE) is more complex, and perhaps because the mechanisms of disease remain unelucidated. The aims of novel therapies in SLE are to target the autoimmune disease at different points: B-cell depletion (Lymphostat-B, Rituximab), inhibition of T-B interaction (IDEC-131), blockade of cytokines (anti-IL-10 antibodies), manipulation of idiotypes (IVIG), tolerance induction to DNA and to Ig-peptides and peptide therapy (Riquent). We review the current knowledge on biologic agents in SLE patients. We utililized MEDLINE for relevant information from 2000 to 2003. Since biologic agents in this disease are at preliminary stages, we include information from abstracts, open trials, as well as phase I, II, and III studies. Anecdotal reports are not included. B-cell depletion therapy is promising.