Sometimes it really is lupus

Each week on the TV show House, Hugh Laurie’s eponymous doctor encountered a patient with a mysterious illness. Each week, one of Dr House’s lackeys would suggest lupus. And, each week, House would grumble: “It’s never lupus.”

It’s not hard to see why systemic lupus erythematosus, or lupus, was a good choice for a gag about a difficult-to-identify disease. Lupus is a chronic, complex multi-organ autoimmune disease with a broad spectrum of symptoms. There is no cure, no single diagnostic test, and it can vary in severity from mild to life-threatening.

Monash University researchers are leading the world’s largest study to describe the disease characteristics, studying 1846 lupus patients from nine countries in the Asia-Pacific Lupus Collaboration.

This will bring us closer to treating lupus sufferers with an approach called treat-to-target, or T2T. Lupus is notoriously hard to measure and treat, and initially, setting targets seemed impossible. But researchers have defined and validated a ‘lupus low disease activity state’. If this state can be maintained, the patient has good long-term outcomes. Dr House would be proud.