Streamline lupus patient care
with GSK GmbH & Co. KG

Systemic lupus erythematosus (SLE) is a chronic, sometimes life-threatening autoimmune disease in which cells of the immune system turn against one’s own body. The term “systemic” reflects that every organ system can be involved. As a result, inflammation and damage occur in the organs affected, for example, the skin, joints, heart, lungs, blood, kidneys, and brain. Characteristic is the so-called butterfly erythema, a reddish rash in the upper cheek area of the face.

Today, an estimated 5 million people worldwide are affected by various types of lupus, including SLE. In Germany, about 30,000 people suffer from SLE. The disease can occur at any age but is mainly diagnosed in younger people aged 15 to 45 years, often massively affecting all aspects of their lives including professional careers, social life and family planning. Over 90% of patients with SLE are women [2,3]

The disease often progresses in flares that are neither predictable nor always look the same. Currently, there’s no cure for SLE. Nowadays, relapses are very rarely fatal, but with each flare, the affected organs are further damaged by inflammation. In particular, the kidneys are often affected, with the risk of developing a chronic kidney disease which over time may lead to a complete loss of renal function. Therefore, patients with lupus are still at least three times more likely to die than the general population[4].

The disease pattern of individual patients is unpredictable. In SLE, acute phases of illness (flares) usually alternate with periods of apparent health (complete or partial remissions). As a result, the quality of life of the patients is severely impaired. In addition to relapses and treatment-related infections, additional illnesses (comorbidities) contribute to increased hospital stays (hospitalizations) and emergency room treatment[5].

SLE is relatively rare, and the symptoms are often non-specific and also occur in other diseases. The assignment of the highly variable symptoms is usually difficult so often there is a delay of years until the correct diagnosis is made[6]. Despite the severeness and the high morbidity and mortality in this relatively young population, many patients don’t reach the defined treatment target of remission or minimized disease activity. The patient pathway in SLE is characterized by delays in diagnosis and inadequate treatment of uncontrolled disease. The main reasons for this are:

• The missing measurement of existing disease activity using a validated score (SLEDAI, etc.)
• The non-adherence to a clearly recommended treat-to-target approach in SLE
• The lack of reflection on the patient’s needs in treatment decisions (SDM)
• High time pressure limiting physician-patient exchange (symptoms, questions, explanations, etc.)
• Underestimation of the risk of organ damage
• Lack of knowledge or misinterpretation of guidelines
• The lack of own experience with modern drugs or bad experience (e.g. by suboptimal patient choice or wrong expectations)
• Cost aspects

In addition to corticosteroids (cortisone for short), a number of drugs that inhibit the immune system are used today to treat lupus. In addition, there are anti-inflammatory drugs, so-called NSAIDs for short time symptomatic treatment only. Drugs that were originally developed for malaria therapy have proven many beneficial effects on lupus and can prevent or alleviate relapses, which is why they are now recommended as the life-long basic therapy for all SLE patients tolerating them.

For some years now, however, there have been new therapeutic approaches with a specific effective targeted mode of action, i.e. those that have been specially developed and approved for the treatment of lupus and intervene specifically in the development and pathogenetic processes of the disease. Clinical studies to date have shown that they can often significantly reduce disease activity and prevent flares, while at the same time being well tolerated by patients. So, the whole causal chain in SLE can be modified: reducing the disease activity and achieving remission leads to less flares, less use of glucocorticoids and both has a beneficial effect on organ damage the key contributor to the high mortality.

Main target group will be clinicians working in the field of rheumatology and/or treating patients with SLE. Solutions also being applicable to office based practitioners and GPs will be preferred.