Lupus最新文献

{"title":"Steroid-induced diabetes in lupus nephritis patients: Classic risk factors or a different type of diabetes?","authors":"Cristian Alejandro Dimas-Ramírez, Luis André Fortanell-Meza, Diego San Agustín-Morales, Eduardo Brenner-Muslera, Juan Manuel Mejía-Vilet, Paloma Almeda-Valdes, Paola Vázquez-Cárdenas, Javier Merayo-Chalico, Ana Barrera-Vargas","doi":"10.1177/09612033251315976","DOIUrl":"https://doi.org/10.1177/09612033251315976","url":null,"abstract":"<p><strong>Background: </strong>Glucocorticoids are frequently employed in systemic lupus erythematosus (SLE) patients and play a critical role in the induction therapy of lupus nephritis (LN), despite their many side effects, including steroid-induced diabetes (SID). Information regarding SID in SLE patients is quite scant.</p><p><strong>Purpose: </strong>The aim of this study was to determine risk factors associated with the development of SID in patients with LN.</p><p><strong>Research design: </strong>A nested case-control study was conducted.</p><p><strong>Study sample: </strong>We included patients with biopsy-proven LN, who received induction treatment with steroids.</p><p><strong>Data collection and/or analysis: </strong>Out of the total of 358 patients, 35 (9.7%) developed SID.</p><p><strong>Results: </strong>Patients with SID had more metabolic risk factors, including the metabolic score for insulin resistance (METS-IR); more factors related with lupus activity, with higher SLEDAI and SLICC-DI scores; and lower cumulative pre-induction steroid dose. A higher percentage of patients who developed SID received steroid pulses and a lower percentage received antimalarials. After logistic regression, the variables significantly associated with the development of SID were the SLEDAI index (OR 1.25 [95% CI 1.04-1.50], <i>p</i> 0.01), SLICC-DI (OR 4.93 [95% CI 2.14-11.3], <i>p</i> < 0.001), METS-IR (OR 1.17 [95% CI 1.04-1.32], <i>p</i> 0.009), delta METS-IR at 6 months (OR 1.20 [95% CI 1.03-1.39], <i>p</i> 0.01), and the use of antimalarials (OR 0.14, [95% CI 0.02-0.85], <i>p</i> 0.03). After propensity score matching, METS-IR remained a significant predictor of SID. Patients with METS-IR >36.8 were at higher risk (OR: 2.83, 95% CI: 1.09-7.36, <i>p</i> = 0.034).</p><p><strong>Conclusions: </strong>In conclusion, SDI development in patients receiving induction therapy for LN is associated with both classic metabolic risk factors and SLE-specific factors, and antimalarial use could be associated with a protective effect. Rheumatologists should be aware of this potential complication, in order to implement appropriate management strategies.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251315976"},"PeriodicalIF":1.9,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thanks to Reviewers.","authors":"","doi":"10.1177/09612033251314644","DOIUrl":"https://doi.org/10.1177/09612033251314644","url":null,"abstract":"","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251314644"},"PeriodicalIF":1.9,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic inflammatory demyelinating polyneuropathy associated with active systemic lupus erythematous: Anifrolumab as a potentially successful add-on therapy to intravenous immunoglobulins.","authors":"Carlos Marques-Gomes, Mariana Diz-Lopes, Luís Braz, Ana Martins, Daniela Oliveira, Rafaela Nicolau, Inês Santos, Lúcia Costa, Miguel Bernardes","doi":"10.1177/09612033251314610","DOIUrl":"https://doi.org/10.1177/09612033251314610","url":null,"abstract":"<p><p>Chronic inflammatory demyelinating polyneuropathy (CIDP) is an acquired, autoimmune peripheral neuropathy, rarely reported as being associated with systemic lupus erythematous (SLE). We report the case of 53-year-old women with a long history of SLE, diagnosed with CIDP during a lupus flare beginning with progressive muscle weakness of lower and upper limbs, without affection of the central nervous system. She received treatment with steroids, intravenous immunoglobulins and anifrolumab and showed clinical and immunological improvement. It is important to take into account the presence of peripheral neurological disorders in patients with SLE, considering CIDP as an uncommon manifestation. Controlling severe active disease is an imperative issue to manage this neurological manifestation which has a serious impact on health-related quality of life and physical function.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251314610"},"PeriodicalIF":1.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proportion, domains, and risk factors of cognitive impairment in systemic lupus erythematosus.","authors":"Anissa Ben Bouzid, Mehdi Somai, Fatma Daoud, Ibrahim Arbaoui, Besma Ben Dhaou, Hedia Bellali, Fatma Boussema, Imene Rachdi, Zohra Aydi","doi":"10.1177/09612033251314592","DOIUrl":"https://doi.org/10.1177/09612033251314592","url":null,"abstract":"<p><strong>Objective: </strong>Cognitive impairment (CI) in systemic lupus erythematosus (SLE) is quite common and is an important prognostic factor due to its severity. The aim of our study was to determine the proportion and type of CI in SLE and to identify associated risk factors.</p><p><strong>Methods: </strong>We performed a cross-sectional study (January - March 2022). Participants included SLE patients and controls (No-SLE). SLE patients were subdivided into those with and those without CI to identify associated risk factors. CI was defined based on the results of eight specific tests assessing various cognitive functions, with MMSE used for overall cognitive assessment. Impairment was indicated by abnormalities in at least five of these eight functions.</p><p><strong>Results: </strong>Our study included 60 lupus and 40 non-lupus participants. The median disease duration of patients in the SLE group was 72 months (interquartile range: 24 - 150 months). The proportion of cognitive impairment in SLE was 31.7%. The comparative study of cognitive functions between the two groups of participants with and without SLE concluded that executive functions and verbal fluency were more impaired in the lupus group compared to the non-lupus group. It also concluded that there were no statistically significant differences in attention and concentration, episodic memory, working memory, calculation, visuospatial and visuoconstructive activity, or judgement. In the multivariate analysis, patients with SLE have a significantly higher risk of CI (Adjusted OR 3.76, 95% CI: 1.217 - 11.621) compared to non-SLE individuals. Each additional year of age increases the risk by 4.4% (Adjusted OR 1.044, 95% CI: 1.008 - 1.082). For factors associated with CI in SLE, the multivariate analysis concluded that the duration of corticosteroid therapy, by months, had an adjusted OR equal to 1.009 (CI (95%): 1.000-1.018), and the duration of education, by years, had an adjusted OR equal to 0.857 (CI (95%): 0.736-0.999).</p><p><strong>Conclusion: </strong>Screening for CI in lupus patients is important, especially for those with factors associated with these disorders such as prolonged duration of corticosteroid therapy and shortened schooling.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251314592"},"PeriodicalIF":1.9,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disease features at diagnosis and changes in disease course severity among commercially insured patients with childhood-onset compared with adult-onset systemic lupus erythematosus.","authors":"Michael E Stokes, Andrea Phillips-Beyer, Qian Li","doi":"10.1177/09612033251314589","DOIUrl":"https://doi.org/10.1177/09612033251314589","url":null,"abstract":"<p><strong>Introduction: </strong>Systemic lupus erythematosus (SLE) causes widespread inflammation and damage in affected organs. Severity is determined by the type of organ systems affected and the extent of involvement. SLE occurs in childhood or adulthood and disease severity varies according to age of onset. We compared disease features and changes in disease severity over time between childhood-onset (cSLE) and adult-onset SLE (aSLE).</p><p><strong>Methods: </strong>Patients 0-64 years old, newly diagnosed with SLE during 2014-2020 were identified using the MarketScan® database. A validated algorithm was used to assess disease severity. Improving severity versus baseline was defined as a transition from a higher (severe) to a lower (mild/moderate) disease state during each evaluation period. Group comparisons were made using the Pearson chi-square test for categorical and <i>t</i> test for continuous measures.</p><p><strong>Results: </strong>A total of 10,912 patients were included. Most (89.9%) were female with a mean age of 14.2 versus 44.6 years for cSLE and aSLE groups, respectively. Patients with cSLE were more likely to have severe disease at diagnosis (38.3% vs 10.7%; <i>p</i> < .0001) versus aSLE. The largest reduction in SLE severity occurred during 6 to <12 months post-index with cSLE experiencing the greatest improvement (36.7% vs 19.9%; <i>p</i> < .0001) compared with aSLE. However, despite improvements observed over time in cSLE, this group was still more likely to have severe disease at 0 to <6 months (26.4% vs 10.5%) and 6 to <12 months (14.4% vs 8.6%) post-index compared with aSLE patients (<i>p</i> < .01, all). For aSLE, the proportions of patients experiencing either an improvement or deterioration in symptoms was similar during 0 to <6 months and 6 to <12 months. However, during 12 to <24 months, nearly twice as many patients in this group experienced a deterioration in symptoms (30.1%) compared to improvement (15.6%).</p><p><strong>Conclusions: </strong>Children with SLE present with greater symptom severity compared with adults. Although children were more likely to experience improvements following treatment, they had more active disease over time than aSLE patients. Disease severity remained stable for aSLE patients until the second year of follow-up, when more patients experienced a deterioration rather than improvement in symptoms.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251314589"},"PeriodicalIF":1.9,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating how patients with lupus nephritis access and trust health information: Results from a Canadian survey of patients with lupus nephritis.","authors":"Francesca S Cardwell, Susan J Elliott, Megan Rw Barber, Kim Cheema, Sydney George, Adrian Boucher, Ann E Clarke","doi":"10.1177/09612033251313578","DOIUrl":"https://doi.org/10.1177/09612033251313578","url":null,"abstract":"","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251313578"},"PeriodicalIF":1.9,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare costs of systemic lupus erythematosus in New Zealand.","authors":"Chunhuan Lao, Philippa van Dantzig, Nicola Tugnet, Ross Lawrenson, Douglas White","doi":"10.1177/09612033241308109","DOIUrl":"https://doi.org/10.1177/09612033241308109","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to estimate the annual medical costs of systemic lupus erythematosus (SLE) in New Zealand (NZ).</p><p><strong>Methods: </strong>SLE patients were linked to the Australia and New Zealand Dialysis and Transplant Registry, Pharmaceutical Collection, National Minimum Dataset, National Non-Admitted Patients Collection and Mortality Collection. National direct medical costs of SLE in 2006-2021 and annual costs per patient were estimated. Generalized linear model was used to examine the impact of various factors on medical costs, including ethnicity, gender, age, socioeconomic status and presence of end-stage kidney disease (ESKD).</p><p><strong>Results: </strong>The annual national costs of SLE were stable over time, around NZ$12 million. The average costs were NZ$8,324 (US$5,277, €5,011) per patient per year, with the costs for patients with ESKD being nine times higher than patients without ESKD (NZ$47,143 vs NZ$5,091). The costs per patient for Māori and Pacific were both around twice the costs for European/Others (NZ$13,124 and NZ$11,842 vs NZ$6,153), but the difference attenuated after adjustment for ESKD and other factors. Among patients without ESKD, Asian, males and patients living in the most deprived areas were associated with higher costs. For patients with ESKD, Māori and patients living in the most deprived areas had higher costs.</p><p><strong>Conclusions: </strong>The annual national costs of SLE were stable over time. The increase in pharmaceutical costs were offset by decrease in hospitalisation costs. Costs for patients with ESKD were nine times higher than costs for patients without ESKD. Interventions for slowing the disease progression and preventing ESKD can reduce medical costs.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033241308109"},"PeriodicalIF":1.9,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilisation patterns of immunomodulators and pregnancy outcomes in systemic lupus erythematosus: Insights from Korean national data.","authors":"Yu-Seon Jung, Yeo-Jin Song, Hyeon Ji Lee, Eunji Kim, Soo-Kyung Cho, Yoon-Kyoung Sung, Sun-Young Jung","doi":"10.1177/09612033241310087","DOIUrl":"https://doi.org/10.1177/09612033241310087","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the trends in immunomodulator use and pregnancy outcomes among pregnant women with systemic lupus erythematosus (SLE), a condition requiring medication to maintain disease activity.</p><p><strong>Methods: </strong>This descriptive study used data from the National Health Information Database in Korea from 2002 to 2018. We included 5,044 pregnancies initiated between 2005 and 2017 in 3,120 SLE patients. Annual trends in SLE therapy, drug utilisation patterns during the preconception and pregnancy periods, and pregnancy outcomes were analysed.</p><p><strong>Results: </strong>Pregnancy compatible immunosuppressant (PC-IS) and hydroxychloroquine use during the first trimester were 10.7% and 41.4%, respectively. Most SLE medications exhibited a decline in usage from the preconception period to the first trimester. A prescription rate of 0.9% for pregnancy incompatible immunosuppressants (PIC-IS) was observed during the first trimester, and the incidence of live births, stillbirths, and abortions remained consistent from 2005 to 2017.</p><p><strong>Conclusions: </strong>Insufficient usage of hydroxychloroquine and PC-IS, along with a reduction in PIC-IS usage primarily during early pregnancy rather than before conception, highlights the unmet need for preconceptional family planning with appropriate medication management strategies in SLE pregnancies.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033241310087"},"PeriodicalIF":1.9,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary congophilia as a predictive biomarker of lupus nephritis in pregnant and non-pregnant women with systemic lupus erythematosus.","authors":"Dalia Younis, Rasha Shemies, Mahmoud M Zakaria, Sameha A Omar, Alaa Mosbah, Ghada El-Kannishy, Alaa Sabry, Sherouk Elnagar","doi":"10.1177/09612033241312746","DOIUrl":"https://doi.org/10.1177/09612033241312746","url":null,"abstract":"<p><strong>Background: </strong>Endoplasmic reticulum stress with protein misfolding has been introduced as a key pathogenetic mechanism in lupus nephritis (LN). Pregnancy is thought to exaggerate proteostasis, which leads to the accumulation of potentially pathogenic misfolded proteins in the urine, serum, and placenta particularly in women with preeclampsia. The detection of misfolded proteins is made using Congo red stain, which is referred to as congophilia. This study aimed to assess the predictive value of urinary congophilia as a marker of LN activity in pregnant and non-pregnant LN women.</p><p><strong>Methods: </strong>Urine samples from non-pregnant LN women (<i>n</i> = 45), pregnant LN women (<i>n</i> = 12), as well as pregnant healthy controls (<i>n</i> = 38) were collected. Urinary congophilia was assessed by Congo Red Dot Blot assay. The disease activity was defined according to SLE Disease Activity Index (SLEDAI) score, and SLE Disease Activity Index-Renal Domain (SLEDAI-R) score. Renal biopsy was done for 33 non-pregnant LN women as it was clinically indicated, and modified NIH activity index (AI) was assessed according to the classification of LN by the International Society of Nephrology/Renal Pathology Society (ISN/RPS).</p><p><strong>Results: </strong>Congo red retention (CRR) values were significantly higher for pregnant active LN patients, in comparison with pregnant inactive LN patients (<i>p</i> = .014), as well as pregnant healthy controls (<i>p</i> = .009). Additionally, CRR values were significantly higher for non-pregnant active LN patients, in comparison with non-pregnant inactive LN patients (<i>p</i> = .016), as well as pregnant healthy controls (<i>p</i> ≤ .001). There were significant positive correlations between CRR on one hand, and anti-ds-DNA (r = 0.791, <i>p</i> ≤ .001), serum creatinine (r = 0.620, <i>p</i> ≤ .001), SLEDAI score (r = 0.623, <i>p</i> ≤ .001), as well as SLEDAI-R score (r = 0.473, <i>p</i> = .005) on the other hand. A highly significant negative correlation was detected between CRR, and serum albumin (r = -0.454, <i>p</i> = .001). CRR at a cut point ≥21.85 had 83% sensitivity, and 58% specificity to capture high LN activity status (NIH-AI >10) versus lower LN activity status.</p><p><strong>Conclusion: </strong>Urinary congophilia may add a diagnostic value in patients with LN and can be a reliable marker of disease activity. CRR is related to disease activity rather than pregnancy.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033241312746"},"PeriodicalIF":1.9,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of IFITM3 as a diagnostic biomarker of systemic lupus erythematosus and its association with disease activity based on multi-omics and experimental verification.","authors":"Yan Li, Jimin Zhang, Xiaomei Liu, Xinwei Zhang, Guixiu Shi","doi":"10.1177/09612033241304454","DOIUrl":"10.1177/09612033241304454","url":null,"abstract":"<p><strong>Background: </strong>Systemic lupus erythematosus is a clinically heterogeneous autoimmune disease that lacks reliable diagnostic biomarkers. In our study, we aimed to identify a novel biomarker for the diagnosis and disease activity monitoring of SLE.</p><p><strong>Methods: </strong>Bulk RNA and scRNA-seq datasets were obtained from the Gene Expression Omnibus database. In this study, differential analysis, cell-cell communication algorithm, functional enrichment analysis, human protein map database analysis, protein-protein interaction analysis and immune cell infiltration analysis were utilized to identify the hub genes between SLE and healthy groups. Furthermore, clinical data from 68 SLE patients and 31 healthy controls were collected for verification. Changes in IFITM3 levels were confirmed through quantitative real-time polymerase chain reaction, western blotting, and flow cytometry analyses.</p><p><strong>Result: </strong>Bioinformatic analyses showed that IFITM3 expression was significantly upregulated in peripheral monocytes from patients with SLE. IFITM3 mRNA levels showed a significant diagnostic value for SLE, with an AUC value of 87.14%. IFITM3 expression was associated with the systemic lupus erythematosus disease activity index, as well as C3, C4, and IgG levels. The results of Chi-square test showed that those in the IFITM3-positive group had a higher percentage of several clinical manifestations such as thrombocytopenia, leukopenia, low complement, and fever.</p><p><strong>Conclusions: </strong>These findings indicated an obviously increased expression of IFITM3 in peripheral blood monocytes of patients with SLE and verified IFITM3 as a promising diagnostic marker for SLE and associated with disease activity.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"57-70"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}