Drug-induced lupus erythematosus: current data on the mechanisms development and associated drugs

Golovach I.Yu.¹, Yehudina Ye.D.²

• ¹Feofaniya Clinical Hospital, Kyiv
• ²Clinic of Modern Rheumatology, Kyiv

Summary. Drug-induced systemic lupus erythematosus (DILE) is an autoimmune phenomenon triggered by a certain drug and resulting in a syndrome sharing several features of systemic lupus erythematosus (SLE). The spectrum of DILE has strongly evolved over the past decades, as many of the drugs that were responsible for DILE are barely used nowadays, if at all. Currently, the most common lupus-­inducing drugs are anti TNF, interferons, methyldopa, sulfasalazine, carbamazepine, acebutolol, isoniazid, captopril, propylthiouracil, terbinafine and minocycline. A large number of proton pump inhibitor (PPI)-induced subacute cutaneous lupus erythematosus cases have been reported. 29 DILE case reports published within the last 2 years are summarized in this review. Antitumor necrosis factor (anti-­TNF) drugs were the most frequently (41.7%) reported to introduce systemic DILE in these cases. Chemotherapeutic drugs were the most common drug class (54.5%) involved in subacute cutaneous lupus erythematosus. Potential new pathogenetic mechanisms of DILE formation are described. The issues of differential diagnosis of DILE and SLE, thera­peutic approaches to DILE are considered.