Not all manifestations perforce appear simultaneously, and a time interval of months or years may exist between the appearance of various symptoms. However, any organ, including the skin, hematologic, renal, neuropsychiatric (NP), cardiovascular and/or respiratory systems, can be affected. Constitutional, muco-cutaneous and musculoskeletal signs represent the earliest and most common complaints reported by the majority of SLE patients. The manifestations of SLE are associated with the presence of multiple autoantibodies (Ab) that cause the formation and deposition of immune complexes (ICs), as well as other immune processes. The clinical onset of SLE derives from the interaction between genetic predisposition and environmental, immunological and hormonal factors, with a strong predilection for women of childbearing age. Systemic lupus erythematosus (SLE lupus) is a complex autoimmune disease with a chronic relapsing–remitting course and variable manifestations leading to a spectrum of disease ranging from mild to life-threatening illness. The aim of this paper is to provide an overview of current pharmacological and non-pharmacological treatment options and emerging therapies in SLE. In the context of a holistic approach, growing evidence is emerging of the importance of correct lifestyle habits in the management of lupus manifestations and comorbidities. Novel therapies targeting interferons, cytokines and their receptors, intracellular signals, plasma cells, T lymphocytes and co-stimulatory molecules are being evaluated. In recent decades, SLE treatment has moved from the use of hydroxychloroquine, systemic glucocorticosteroids and conventional immunosuppressive drugs to biologic agents, of which belimumab is the first and only biologic agent approved for the treatment for SLE to date. Moreover, even lupus patients in remission often report residual symptoms, such as fatigue, which have a considerable impact on their health-related quality of life. Despite recent improvements in the treatment of systemic lupus erythematosus (SLE), disease activity, comorbidities and drug toxicity significantly contribute to the risk of progressive irreversible damage accrual and increased mortality in patients with this chronic disease.
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