The latest strategies for the clinical management of systemic lupus erythematosus (SLE) were discussed at the most recent instalment of Weill Cornell Medicine – Qatar’s (WCM-Q) Grand Rounds.
Dr Mohamed Yousuf Karim, assistant professor of clinical pathology and laboratory medicine at WCM-Q, summarised recent advances in the tools used by physicians in the investigation and clinical management of patients with SLE, before discussing the limitations and barriers to progress of new personalised medicine approaches to SLE treatment.
SLE, commonly referred to as lupus, is a debilitating chronic autoimmune disorder characterised by symptoms that can include painful, swollen joints, a rash (commonly on the face), fever, chest pain, hair loss, mouth ulcers, swollen lymph nodes, and tiredness.
SLE can also affect the heart, lungs, kidneys, eyes, reproductive system and have neuropsychiatric effects.
Because SLE manifests in very different ways between patients, personalised medicine approaches are considered promising but to date have not delivered the same level of benefit to patients as more general approaches.
Speaking to an audience of physicians, nurses, dentists, pharmacists, allied health professionals, students, researchers and educators, Karim said: “Out of all the things that have brought about improvements to patients with lupus, personalisation is probably the least important, but it is something that has a great, great deal of potential.
“Essentially, personalised approaches could help us determine which drugs to use for which patient, in which order and at the risk of which side effects.
“These are the things that patients are interested in.”
He said that barriers to progress in research into the use of personalised approaches for lupus treatment include the heterogeneity or high level of differentiation of the disease, poor understanding of how ethnicity affects the disease, difficulty recruiting sufficient numbers of people from different ethnic groups to participate in trials, high variation in disease outcomes between different countries, and problems defining inclusion criteria for trials, among others.
Strategies for overcoming these barriers include standardising how lupus is defined and how data is collected by research networks, using multi-platform and multi-dimensional analytical approaches, and then using the subsequent data to stratify patients and inform therapeutic choices, leading to improved healthcare outcomes.
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