New Guidelines for Diagnosis and Treatment of Lupus

The University of Birmingham has developed new guidelines for taking care of adults living with lupus. These are the latest documents that concern those living with the autoimmune disease. These include the most recent recommendations for diagnosis and treating the mild, moderate, and severe forms of lupus.

Women of childbearing age and ethnic minorities like those of Caribbean, African, and Asian descent are at higher risk than others. Although lupus is not a widely prevalent disease, undoubtedly it is a condition resulting in a decreased lifespan, even in developed nations whose average age of those living with lupus is 20-25 years, which is lower than the national average. The most significant reason for higher mortality rates is an increased perception to various infections and cardiac problems. About one-third of these cases with lupus may also have renal issues.

It is essential to revise the guidelines for autoimmune disorders, as they are seeing an upsurge along with a change in the nature of the disease pattern. Nowadays there is the tendency of more women being diagnosed with lupus after 40 years of age.

For the last fifty years, lupus has remained among one of the more neglected ailments, as it attracted very little research efforts. For several years, mainstay of treatment has been anti-inflammatory drugs, steroid hormones, antimalarial, and immunosuppressants. Progress in finding a cure has been so slow that in the last half a century just one drug named belimumab has been explicitly approved for the treatment of lupus. Even this drug has received criticism as it was primarily tested in mild to moderate cases of lupus, leaving out the more severe and aggressive cases of the disease.

Why is there a need for a new guideline?

The disease remains a challenge for medical specialists. The average survival rate of lupus is progressively declining and little has changed in the last half a century. For this reason, new guidelines are a must because:

• It is a multi-organ disease, requiring care by a multi-specialist team.
• No single blood test is diagnostic of lupus and it is not easy to diagnose since it's based on clinical symptoms.

Latest criteria to diagnose lupus

The American Rheumatism Association proposed one of the first principles to diagnose lupus. It recommended the eleven criteria that were a mix of clinical symptoms and immunological tests. Someone would be considered to be suffering from lupus if four or more items were found to be true. However, it has low accuracy primarily due to putting both clinical symptoms and results of immunological findings in a single table.

This led to the development of new diagnostic criteria developed by the SLICC group. It is a criterion that is now widely accepted by European, American and other global health agencies. As per the SLICC group recommendations, a person may be diagnosed to be suffering from lupus if he or she has met four of the criteria from the list, but there should be at least one criterion to be met from the clinical or immunological group.