Systemic lupus erythematosus (SLE) is a pleiotropic disease that can present in numerous forms, ranging from mild mucocutaneous symptoms to severe manifestations affecting multiple organs. SLE has the potential to impact any segment of the respiratory system, exhibiting a range of severity levels throughout the different stages of the disease. Pulmonary manifestations in SLE patients can be classified as primary (i.e., directly related to SLE and to immune-mediated damage), secondary to other SLE manifestations (e.g., nephrotic syndrome, renal failure, congestive heart failure), and comorbidities (e.g., infections, cancers, overlapping primary respiratory diseases). Understanding and correctly managing lung involvement in SLE is crucial because pulmonary complications are common and can significantly impact morbidity and mortality in affected patients. Early recognition and appropriate treatment can prevent irreversible lung damage, improve quality of life, and reduce the risk of life-threatening complications. Treatment algorithms are based on the suppression of inflammation, with or without the need for dedicated, supportive care. According to disease severity, available treatments include nonsteroidal anti-inflammatory drugs, corticosteroids, immunosuppressants, and biological agents. In this review, we aim to summarize the current knowledge on lung involvement in SLE and then focus on the management and treatment approaches available for the different forms.

Efficacy of Mepolizumab in a cohort of patiens with severe eosinophilic asthma and bronchiectasis after 6 years of treatment: a single centre study Introduction: Mepolizumab is a humanized monocolonal antibody against IL5, mostly used in patients with severe eosinophilic asthma. Aim: To describe clinical improvement and safety of Mepolizumab in patients with severe eosinophilic asthma and bronchiectasis in real life after 6 years Methods and Materials: 86 patients with severe eosinophilic asthma have been enrolled (40 females) mean age 62y (range 21-82), identified according to the most recent guidelines. They started Mepolizumab treatment from January 2018 and they were followed up until December 2023. 17 patients (12 females) mean age 61.1y (range 41-79) had bronchiectasis. Chest HRCT showed abnormal cylindrical dilatation of the bronchial tree, lack of tapering, bronchial wall thickening, mucoid impaction and specific signs, such as signet ring sign and tram-track sign. Results: After 6 years it has been demonstrated a reduction of infectious exacerbations from 2.1 events/y pre-treatment to 0.4 events/y post treatment and a less use of antibiotics to treat them. No adverse reactions have been recorded during the treatment with Mepolizumab. Conclusions: Mepolizumab improves the symptomatology in patients with severe eosinophilic asthma and bronchiectasis and reduces the frequency of the infectious exacerbations and adverse outcomes.

Introduction: Mepolizumab is a monoclonal antibody mostly used in patients with severe eosinophilic asthma. Aim: To describe the efficacy and safety of Mepolizumab in severe eosinophilic asthma in real life after 5 years treatment in a Centre for care of Severe Astma. Methods and Materials: We analysed the primary endpoint of rate of decline in FEV1 in patients before and after using Mepolizumab from January 2018 to december 2022. Patients’ clinical features have been registered, as well as tolerability to Mepolizumab and respiratory function test in a cohort of patients with severe eosinophilic asthma. Results: 59 patients with severe eosinophilic asthma have been enrolled, 20 males and 39 females, mean 60 yo (range 21-82 y) with severe eosinophilic asthma, identified according to the most recent guidelines. The results have showed a statistically significance about the improvement of FEV1’s value before the Mepolizumab treatment and the FEV1’s value after 5 years, with a p-value of 0.0005. The mean of Δ (delta) pre-mepolizumab and Δ post-mepolizumab equals 14,35; the 95% confidence interval of this difference ranges from 6.48 to 22.22, standard error was calculated with value of 3.937. It also has been recorded a reduction of the frequency of exacerbations from 3-5 events/y pre-treatment to 1-2 events/y post-treatment and the OCS’ dosage from an average of 41,4 mg/d to an average of 29,2 mg/y. No adverse reactions has been recorded during the treatment with Mepolizumab. r code Conclusions: Mepolizumab improves respiratory function, reduces the frequency of the exacerbations and the OCS’ use in patients with severe asthma ipereosinophilic.