EVALUATION OF THE USE OF IMMUNOSUPPRESSIVE THERAPIES IN PATIENTS WITH REFRACTORY SYSTEMIC LUPUS ERYTHEMATOSUS: LONG-TERM EFFICACY AND SAFETY

Abstract

Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease that can involve multiple organs and systems, often with unpredictable progression and refractoriness to conventional treatments. The use of immunosuppressive therapies has been central to the management of refractory cases; however, the long-term efficacy and safety of these therapies remain areas of intensive study. This study aims to evaluate the impact of the use of immunosuppressive therapies in patients with refractory SLE, addressing the efficacy in controlling clinical manifestations and long-term safety. The integrative review of clinical and observational studies allowed the analysis of different therapeutic regimens, including cyclophosphamide, mycophenolate mofetil, rituximab, and belimumab, focusing on therapeutic results and prolonged adverse effects. The review highlights that although there is evidence of efficacy for these therapies, with reduction of flares and improvement in some clinical outcomes, long-term safety remains a challenge, with potential adverse effects, including infections, hematologic toxicity, and malignancy. These findings reinforce the need for continuous monitoring and individualization of treatment to optimize benefits and minimize therapeutic risks.