Emerging treatments for systemic lupus erythematosus

It is well known that the failure of multiple past clinical trials of systemic lupus erythematosus (SLE) partly depends on the clinical and immunological heterogeneities of the disease. Appropriate trial designs, endpoints, and patient populations are required to assess the efficacy of SLE treatments. At the same time, interdisciplinary research is gradually revealing multiple targets that contribute to the pathophysiology of SLE. Currently, molecular-targeted therapies tailored to the disease are being developed as treatment strategies that do not rely on glucocorticoids. With the introduction of new treatments and technologies, clinical trials for SLE have significantly accelerated over the past decade. More than 300 interventional studies on SLE and lupus nephritis, both ongoing and planned, are underway. Various trials targeting different pathways are currently being conducted and SLE treatment strategies may be on the verge of a turning point in the near future. However, some challenges remain. In this review, we focus on promising agents in phase 2 clinical trials and beyond to highlight the latest perspectives and unresolved issues related to targeted therapies for SLE, as well as to explore future research directions and therapeutic strategies required for the implementation of personalised medicine for this rare disease.