Systemic lupus erythematosus.

Introduction Systemic lupus erythematosus (SLE) occurs predominantly in young women, but also in children. The prevalence of SLE varies widely worldwide, ranging from about 1 in 3500 women (regardless of race) in the UK, to 1 in 1000 women in China, to 1 in 250 black women in the USA. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments on joint (arthralgia/arthritis) symptoms and other non-organ-threatening symptoms such as serositis and fatigue in people with systemic lupus erythematosus? What are the effects of interventions for cutaneous involvement in people with systemic lupus erythematosus? What are the effects of treatments in people with proliferative (WHO grades 3-5) lupus nephritis? What are the effects of treatments for neuropsychiatric involvement in people with systemic lupus nephritis? We searched: Medline, Embase, The Cochrane Library and other important databases up to April 2006 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found eight systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: acitretin, antipsychotic drugs, chloroquine, combination corticosteroids plus immunosuppressants, corticosteroids, hydroxychloroquine, intravenous immunoglobulin, methotrexate, non-steroidal anti-inflammatory drugs, plasmapheresis, and sun block.