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Lupus Science & Medicine

Renaud Felten, Flora Sagez, Pierre-Edouard Gavand, Thierry Martin, Anne-Sophie Korganow, Christelle Sordet, Rose-Marie Javier, Pauline Soulas-Sprauel, Marianne Rivière, Florence Scher, Vincent Poindron, Aurélien Guffroy, Laurent Arnaud
From a 1-year survival of less than 50% before the discovery of glucocorticoids to over 90% at 10 years in most dedicated centres, the spectrum of SLE has profoundly evolved. Despite this improvement, several major challenges currently remain. The aim of this review is to analyse what are, according to us, the 10 most important contemporary challenges in the management of SLE. Among those are the need to treat to target to favour disease remission (or low disease activity), limit the use of glucocorticoids, derive more comprehensive tools for the evaluation of disease activity, develop more effective drugs (yielding successful trials), dissect the heterogeneity of the disease both at the molecular and genetic levels, identify relevant biomarkers for individualised treatment, manage fertility and pregnancy, tackle comorbidities such as cardiovascular risk, the prevention of infections and osteoporosis, improve the network of care (from the patients' perspective), and favour a holistic approach (integrating fatigue, adherence to treatment, physical activity)...
2019: Lupus Science & Medicine
Ellen M Ginzler
No abstract text is available yet for this article.
2018: Lupus Science & Medicine
(no author information available yet)
[This corrects the article DOI: 10.1136/lupus-2018-000286.].
2018: Lupus Science & Medicine
Aderike Anjorin, Peter Lipsky
SLE is a complex autoimmune disease with genetic and clinical differences between patients that appear to reside along ancestral lines. Over the last 20 years, a preponderance of evidence has shown that SLE is more common and severe in minority populations, particularly in African ancestry (AA) women. However, in clinical trials for new therapies of SLE, AA is often under-represented. Without enrolling sufficient AA participants, it is difficult to ascertain the safety and efficacy of new potential therapies among individuals with SLE of different ancestries...
2018: Lupus Science & Medicine
Ronald F van Vollenhoven, William Stohl, Richard A Furie, Norma Lynn Fox, James G Groark, Damon Bass, Milena Kurtinecz, Bonnie F Pobiner, William J Eastman, Tania Gonzalez-Rivera, David Gordon
Objective: The Systemic Lupus Erythematosus (SLE) Responder Index (SRI), developed as a primary outcome measure for use in clinical trials, captures improvement in SLE disease activity without concomitant worsening in disease manifestations. This study investigated the relationships between the SRI and clinical/laboratory correlates of SRI response in patients with SLE. Methods: This was a post-hoc analysis of the phase III, double-blind, placebo-controlled study of subcutaneous BeLimumab in Subjects with Systemic lupus erythematosus - SubCutaneous (BLISS-SC)...
2018: Lupus Science & Medicine
Joan T Merrill, Richard Furie, Victoria P Werth, Munther Khamashta, Jorn Drappa, Liangwei Wang, Gabor Illei, Raj Tummala
Objective: This post hoc analysis compared anifrolumab 300 mg every 4 weeks with placebo on rash and arthritis measures with different stringency in patients with moderate to severe SLE (phase IIb; MUSE; NCT01438489). Subgroups were analysed by type I interferon gene signature (IFNGS test-high or test-low). Methods: Rash was measured with the SLE Disease Activity Index 2000 (SLEDAI-2K), British Isles Lupus Assessment Group (BILAG) Index and modified Cutaneous Lupus Erythematosus Disease Area and Severity Index (mCLASI)...
2018: Lupus Science & Medicine
Alba Santos, Gilbert Greub, Sébastien Aeby, Dorothea Wunder, Giuseppe Pantaleo, Camillo Ribi
Background: SLE is an autoimmune condition affecting predominantly women. Little is known regarding Chlamydia trachomatis infection in women with SLE, which may drive autoimmunity and contribute to obstetrical and vascular complications. Methods: This single-centre, case-control study set primary endpoint in the comparative seropositivity rate to C. trachomatis major outer membrane protein (MOMP) and chlamydial heat-shock protein-60 (cHSP60) in age-matched subjects...
2018: Lupus Science & Medicine
Ioanna Giannakou, Katerina Chatzidionysiou, Laurence S Magder, Noemi Györi, Ronald van Vollenhoven, Michelle A Petri
Objectives: The aim of this study is to identify prognostic factors of persistent disease activity and long quiescence in systemic lupus erythematosus (SLE). Methods: Patients enrolled in the Hopkins Lupus Cohort from 1987 to 2012, who attended at least three visits per year during 3 consecutive years following baseline and had available information on disease activity were included. Patterns of SLE disease activity over the 3-year period were defined as: persistent long quiescent (pLQ), persistent relapsing-remitting (pRR), persistent chronic active (pCA) and mixed based on Modified SLE Disease Activity Index (M-SLEDAI)...
2018: Lupus Science & Medicine
Kerry A Casey, Xiang Guo, Michael A Smith, Shiliang Wang, Dominic Sinibaldi, Miguel A Sanjuan, Liangwei Wang, Gabor G Illei, Wendy I White
Objective: Anifrolumab is a fully human immunoglobulin G1 κ monoclonal antibody specific for subunit 1 of the type I interferon (IFN) α receptor. In a phase IIb study of adults with moderate to severe SLE, anifrolumab treatment demonstrated substantial reductions in multiple clinical endpoints. Here, we evaluated serum proteins and immune cells associated with SLE pathogenesis, type I interferon gene signature (IFNGS) test status and disease activity, and how anifrolumab affected these components...
2018: Lupus Science & Medicine
Ashwaq AlE'ed, Pinar Ozge Avar Aydin, Nora Al Mutairi, Alhanouf AlSaleem, Hafize Emine Sonmez, Michael Henrickson, Jennifer L Huggins, Seza Ozen, Sulaiman M Al-Mayouf, Hermine I Brunner
Objective: To determine the measurement properties of the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) and the paediatric adaptation of the Skindex29 (pSkindex27) when used in childhood-onset SLE (cSLE). Methods: Patients with mucocutaneous involvement of cSLE were evaluated at the study entry and 6 months later. Besides the CLASI and pSkindex27, the Pediatric Quality of Life Inventory Generic Core scale (PedsQL-GC), its Rheumatology Module (PedsQL-RM), the SLE Disease Activity Index (SLEDAI) and the SLE Damage Index (SDI) were completed...
2018: Lupus Science & Medicine
Chiara Tani, Elena Elefante, Miguel Martin-Cascón, Meriem Belhocine, Cristina Lavilla Olleros, Roberta Vagelli, Chiara Stagnaro, Nathalie Costedoat-Chalumeau, Guillermo Ruiz-Irastorza, Marta Mosca
Objectives: To analyse the real-life practice on the use of Tacrolimus (TAC) in patients with systemic lupus erythematosus (SLE) from three European SLE referral centres. Methods: Adult patients with SLE regularly followed at three European referral centres were included. Demographics, cumulative organ involvement, treatment history, Systemic Lupus Disease Activity Index (SLEDAI), laboratory features and physician's judgement were collected at baseline and at 3-6-12 months after starting TAC...
2018: Lupus Science & Medicine
Sahena Haque, Sarah Skeoch, Chadi Rakieh, Helena Edlin, Yasmeen Ahmad, Pauline Ho, Rachel Gorodkin, M Yvonne Alexander, Ian N Bruce
Objectives: We aimed to describe the rate and determinants of carotid plaque progression and the onset of clinical cardiovascular disease (CVD) in a UK SLE cohort. Methods: Female patients with SLE of white British ancestry were recruited from clinics in the North-West of England and had a baseline clinical and CVD risk assessment including measurement of carotid intima-media thickness (CIMT) and plaque using B-mode Doppler ultrasound. Patients were followed up (>3...
2018: Lupus Science & Medicine
Zhuang Wang, Bettina Heid, Rujuan Dai, Sattar Ansar Ahmed
Objective: MicroRNAs (miRNAs) play an important role in the pathogenesis of various autoimmune diseases including systemic lupus erythematosus (SLE; lupus). We have previously reported a common pattern of miRNA dysregulation in splenic lymphocytes from several mouse models of lupus. In this study, we investigated whether there is a similar miRNAs expression dysregulation in peripheral blood mononuclear cells (PBMCs) and splenocytes in a classical murine lupus model, MRL/lpr. Method: PBMCs were isolated from blood samples of control MRL and lupus MRL/lpr mice aged 14-15 weeks by gradient centrifugation with Histopaque 1083 density media...
2018: Lupus Science & Medicine
(no author information available yet)
[This corrects the article DOI: 10.1136/lupus-2018-000279.].
2018: Lupus Science & Medicine
Molly K Hritzo Ahye, Amit Golding
Systemic lupus erythematosus (SLE) is a manifestation of hyperactivated lymphocytes and results, in part, from the loss of normal tolerance checkpoints. FOXO1 is a transcription factor involved at critical early and late B cell development checkpoints; however, its role in regulating peripheral B cell tolerance is not fully understood. We have applied our published approach for using imaging flow cytometry to study native FOXO1 localisation in human lymphocytes to peripheral blood samples from healthy individuals versus patients with SLE...
2018: Lupus Science & Medicine
Josef Symon Salgado Concha, Victoria P Werth
Several patterns of hair loss can occur in lupus erythematosus (LE). Alopecias which show histological characteristics of LE are LE-specific, and include discoid LE (DLE), diffuse or patchy hair loss in acute LE, subacute cutaneous LE, and rarely tumid LE. Lupus hair in SLE is a poorly characterised entity and may be a form of telogen effluvium. Alopecia areata can coexist with LE and may mimic DLE. Non-lupus alopecias such as telogen effluvium and anagen effluvium have a myriad of causes which include disease flares, drugs and stress in the setting of LE...
2018: Lupus Science & Medicine
Yu Matsueda, Yoshiyuki Arinuma, Tatsuo Nagai, Shunsei Hirohata
Objective: Recent studies have demonstrated that autoantibodies directed against glucose-regulated protein 78 (GRP78) on endothelial cells promote blood-brain barrier (BBB) damages. The present study examined whether serum anti-GRP78 antibodies might be involved in the pathogenesis of neuropsychiatric SLE (NPSLE). Methods: Serum samples were obtained from 129 patients with SLE (58 patients with diffuse psychiatric/neuropsychological syndromes of NPSLE (diffuse NPSLE), 30 with neurological syndromes (focal NPSLE), 21 with lupus nephritis (LN), 20 without NPSLE or LN (SLE alone)), from 35 patients with non-SLE rheumatic diseases (non-SLE RD) and from 24 healthy controls (HC)...
2018: Lupus Science & Medicine
Fabien B Vincent, Laura Slavin, Alberta Y Hoi, Arthur Richard Kitching, Fabienne Mackay, James Harris, Rangi Kandane-Rathnayake, Eric F Morand
Objective: To characterise the clinical relevance of urinary macrophage migration inhibitory factor (uMIF) concentrations in patients with systemic lupus erythematosus (SLE). Methods: MIF, adjusted for urine creatinine, was quantified by ELISA in urine samples from 64 prospectively recruited patients with SLE. Serum MIF and urinary monocyte chemoattractant protein 1 (uMCP-1) were quantified by ELISA in a subset of patients (n = 39). Disease activity was assessed using the SLE Disease Activity Index-2000 (SLEDAI-2K) score...
2018: Lupus Science & Medicine
Aleksandra Antovic, Maria Sennström, Katarina Bremme, Elisabet Svenungsson
The present clinical and laboratory classification criteria for antiphospholipid syndrome (APS) were established in Sydney, Australia, in 2006. In this review, we focus on the obstetric subset of APS (OAPS), defined by persistent positivity for antiphospholipid antibodies together with either early recurrent pregnancy loss, early fetal death, stillbirth or premature birth <34 gestational weeks due to pre-eclampsia, eclampsia and placental insufficiency. It is important to diagnose these cases since most women suffering from OAPS can, when given appropriate treatment, have successful pregnancies...
2018: Lupus Science & Medicine
Mimi Kim, Joan T Merrill, Kenneth Kalunian, Leslie Hanrahan, Peter Izmirly
Objective: To evaluate response duration and identify predictors of transitioning into and out of the response state in patients with SLE receiving standard of care (SoC) in 52-week clinical trials. Methods: A multistate model (MSM) allowing for bidirectional transitions between response and non-response states was fit to data on 759 patients with SLE with active disease randomised to SoC. The probability of being in response at 52 weeks, average duration of response (sojourn time) and mean total time in response for SLE Responder Index (SRI-4, SRI-5, SRI-6) and BILAG-based Composite Lupus Assessment (BICLA) were estimated...
2018: Lupus Science & Medicine
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