An Osteopathic Approach to the Management of Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that primarily affects women and people of Hispanic, African, and Asian descent. The treatment goals are similar to other autoimmune diseases: preventing progressive damage to organs and decreasing disease activity to increase patient quality of life. Steroids can lead to rapid control of symptoms but have many long-term side effects; patients should be transitioned to steroid-sparing agents and new biologics when possible. Special populations require specific considerations, such as those experiencing renal or neuropsychiatric symptoms or drug side effects or those who are pregnant or planning to conceive. Sustained remission is very difficult to achieve, and current guidelines recommend targeting a low SLE activity state to optimize quality of life. An osteopathic approach to managing SLE attempts to reflect the principles of osteopathy into evidence-based medicine to optimize quality of life.