Of 11,996 articles, 15 articles were reviewed for this systematic review that were relevant to clinical research topic. The results from the articles were used to address the question which treatment immunosuppressives or corticosteroids is better in treating adolescents with systemic lupus erythematosus. Immunosuppressives reviewed in this paper are Hydroxychloroquine, Methotrexate, Cyclophosphamide, Rituximab, Azathioprine, Mycophenolate Mofetil, Anti-cytokines (including anti-TNF therapies such as Etanercept, Infliximab and Adalimumab). For corticosteroids there are Glucocorticoid, Prednisone and Methylprednisolone.
Hydroxychloroquine
Hydroxychloroquine (HCQ) is an antimalarial medication that is used to treat childhood-onset …show more content…
It is a disease-modifying anti-rheumatic drug (DMARD) which is designed to moderate the immune system by targeting cytokines, affecting the presentation of antigens and suppressing the stimulation and rapid reproduction of T and B cells (Craig, 2010). According to Arici, Batu, & Ozen (2015) MTX was effective in patients whose SLE had not responded to prior treatments. Furthermore, in a prospective, controlled study, patients on low dose MTX showed equal improvement compared to individuals on chloroquine, an antimalarial drug often used to treat SLE patients, regarding articular and cutaneous manifestations of the disease (Arici et. al, 2015). Thorbinson, Oni, Smith, Midgley, & Beresford (2016) list the side effects of MTX which range from mind to sever. These side effects include bone marrow suppression, nausea and vomiting and liver inflammation. Overall MTX is an effective medication for patients whose SLE has not responded to prior treatments and/or those who have cutaneous and articular manifestations of the …show more content…
Rituximab has been successful in treating other autoimmune disorders such as non-Hodgkin’s lymphoma and rheumatoid arthritis. B cell depletion therapy was successful in the testing of mice with SLE, but some human trials failed. “The Lupus Nephritis Assessment With Rituximab (LUNAR) trial investigated rituximab versus placebo in addition to standard care (mycophenolate mofetil and glucocorticoids) in adult patients with LN” (Thorbinson et al, 2010, 188). This study also failed, however, “post hoc analysis showed a beneficial effect of rituximab in specific subgroups” (Thorbinson et al, 2010,