IMMUNOMODULAR THERAPIES IN THE TREATMENT OF AUTOIMMUNE DISEASES: AN INTEGRATIVE REVIEW OF CLINICAL EVIDENCE

Abstract

Introduction: Autoimmune diseases arise from a dysregulated immune response in which the immune system attacks the body's own tissues. These diseases, such as systemic lupus erythematosus, rheumatoid arthritis, and multiple sclerosis, present great variability in their symptoms and severity. In recent years, immunomodulatory therapies have emerged as a promising approach to control the progression of these diseases and improve the quality of life of patients, acting directly on the modulation of the immune response. Objective: This integrative review aims to analyze the clinical evidence on the efficacy of immunomodulatory therapies in the treatment of autoimmune diseases, focusing on their mechanisms of action, safety, and clinical outcomes. Methodology: An integrative review was performed in the PubMed, Scopus, and Web of Science databases, covering studies published between 2012 and 2023. Randomized controlled trials, systematic reviews, and cohort studies that evaluated the efficacy of immunomodulatory therapies, such as cytokine inhibitors, T- and B-cell modulators, and biologic agents, were included. A total of 35 studies were selected for detailed analysis. Results and Discussion: Immunomodulatory therapies have been shown to be effective in reducing disease activity and clinical symptoms in several autoimmune diseases. Cytokine inhibitors, such as anti-TNF and anti-IL-6, were effective in the treatment of rheumatoid arthritis and Crohn's disease, improving inflammation and slowing disease progression. T- and B-cell modifiers, such as rituximab, have shown good results in the management of diseases such as lupus and multiple sclerosis, with a significant reduction in relapse rates. However, studies also highlight challenges related to prolonged immunosuppression, including increased risk of infections and malignancies. The need for close monitoring and personalization of therapies to optimize outcomes and minimize adverse effects are crucial aspects. Conclusion: Immunomodulatory therapies have shown great potential in the management of autoimmune diseases, offering an effective approach to control disease progression and improve clinical outcomes. However, their long-term efficacy and the risks associated with immunosuppression require ongoing care and personalized treatment strategies.