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CME: Systemic lupus erythematosus (SLE): therapeutic updates and optimizing treatment

Activity Description / Statement of Need:

In this online CME self-learning program:


Systemic lupus erythematosus (SLE) is an autoimmune disease with heterogeneous clinical phenotypes, all with varying degrees of severity. Much like the clinical presentation of SLE, the etiology of SLE is also varied. Although the precise mechanism of SLE-related autoimmunity is still uncertain, strong evidence implicates a combination of genetic and environmental factors in the disease pathology. For most of the medical community, the primary challenges of SLE management stem from the disease heterogeneity, which leads to difficulty in diagnosing, treating, and monitoring.


Early diagnosis is an important component of improving outcomes for patients with SLE, yet many patients experience significant diagnostic delays. When patients are stratified based on the length of diagnostic lag, those with less than 6 months from probable symptom onset to time of diagnosis have fewer flares and hospitalizations compared with those who have more than 6 months of diagnostic delay. Furthermore, patients in the late diagnosis group have significantly higher inpatient costs per month compared with the early diagnosis group ($539 vs $411, respectively, P = 0.001).




Faculty introduction, disclosures

Epidemiology and etiology of SLE.

  • Incidence, prevalence, and demographics
    • Mortality & morbidity
    • Updates in the pathophysiology of SLE
      • Genetic factors and genome-wide association studies
      • Immunologic factors – the importance of B-cells
      • Environmental factors

The importance of early diagnosis.

  • Impact of diagnostic delay on outcomes
    • Mortality, morbidity, organ damage accrual, flares
    • Classification criteria
      • Diagnostic versus classification criteria
      • Application of criteria
      • Serologic tests
      • The need for thorough patient and family histories
      • Emerging biomarkers

Treat-to-target in SLE practice

  • Selection of targets
    • Remission: With or without steroids?
    • Low disease activity
    • Other targets
    • Modification of treatment regimens
    • Induction therapy
    • Minimization of steroid therapy
      • Low dose steroids
      • No steroids
      • Use of biologic agents for reaching target
        • Pipeline drugs
        • Contextualizing clinical trials: Design difficulties
        • Combination therapy
        • Antimilarials and other immunomodulatory drugs
        • Anti-inflammatory drugs
        • Barriers to care: access, adherence, and engaging and educating the patient
        • Patient case(s)

Summary, best practice recap, conclusion

Target Audience:

The following HCPs: rheumatologists and primary care physicians; physician assistants, nurse practitioners, nurses, and pharmacists who practice in rheumatology; and any other HCP with an interest in or who clinically encounter patients with SLE.

This program is supported by an educational grant from Mallinckdrodt

Release Date: April 01, 2017 -- Expiration Date: April 01, 2019

Faculty: Sharon Dowell, MD


Learning Objectives

By the end of the session the participant will be able to:

  • Describe the pathophysiology of systemic lupus erythematosus (SLE), with a focus on the factors affecting disease progression, remission, and therapeutic mechanisms.
  • Identify symptoms of SLE and optimize diagnostic procedures to initiate treatment as early as possible.
  • Discuss treat-to-target strategies for SLE, and define therapeutic targets with patients based on shared treatment goals.
  • Evaluate available and emerging therapeutic options for SLE, and individualize treatment regimens based on patient and disease characteristics.



Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review ScientiaCME.


Faculty Disclosure:  Sharon Dowell, MD, Assistant Professor of Medicine Howard University Hospital, Washington, DC discloses that she received Research grant support from Bristol-Myers Squibb, Pfizer, and Genentech; is a member of the Speaker’s Bureau of Horizon Pharma, and has received funding for Clinical Trials from GlaxoSmithKline.


Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP has no relevant conflicts of interest to disclose.


Commercial Support Disclosure: This program is supported by an educational grant from Mallinkdrodt.


  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowedge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Take the post-test
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural and Linguistic Competence

System Requirements

Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version

Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.

Additional Courses That Are Related To This Activity

Psoriasis: Best Practices, Barriers to Care, and Emerging Therapies in Medication Management

Psoriatic Arthritis: Therapeutic Updates and Optimizing Treatment

Systemic lupus erythematosus (SLE): therapeutic updates and optimizing treatment

Rheumatoid Arthritis (RA): Optimizing Pharmacotherapeutic Management Strategies