Lupus最新文献

{"title":"Hypertension is associated with global and renal damage accrual in patients with systemic lupus erythematosus. Data from the Almenara Lupus Cohort.","authors":"Fernando Piero Díaz-Ramírez, Fiorella Vanessa Saldaña-Alvarado, Rocío V Gamboa-Cárdenas, Victor Pimentel-Quiroz, Cristina Reategui-Sokolova, Claudia Elera-Fitzcarrald, Erika Noriega, Zoila Rodriguez-Bellido, Cesar Pastor-Asurza, Risto Perich-Campos, Graciela S Alarcón, Manuel F Ugarte-Gil","doi":"10.1177/09612033251319397","DOIUrl":"10.1177/09612033251319397","url":null,"abstract":"<p><p>ObjectivesTo determine the association between the occurrence of hypertension and damage accrual in patients with systemic lupus erythematosus (SLE).Materials and methodsFrom January 2012 to January 2020, we evaluated 314 SLE patients, all members of the Almenara Lupus Cohort. We applied the American College of Cardiology/American Heart Association (ACC/AHA) guidelines to define hypertension, the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) to determine organ damage, and the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI-2K) to assess disease activity. We performed univariable and multivariable analysis using generalized estimating equations, adjusting for potential confounders (demographic factors, disease-related factors and treatment).Results314 patients and 1695 visits were included; 93% of the patients were women. Their mean disease duration was of 6.8 years (SD: 6.4), and their age at diagnosis of 35.7 (SD: 13.4) years. Baseline damage was 0.8 (SD: 1.2) at the first visit, increasing by 0.15 points at the subsequent follow-up visit (SD: 0.46). The prevalence of hypertension in these patients was 56.4% at least once during their follow-up. In the multivariable analysis, hypertension remained associated with damage accrual (IRR: 1.645, 95% CI: 1.187-2.280, <i>p</i> = 0.003) after adjusting for confounders. In the analyses performed per domain, hypertension was associated with renal damage in the multivariable model (OR: 4.331, 95% CI 1.547-12.126, <i>p</i> = 0.005).ConclusionHypertension was associated with subsequent greater damage in our SLE patients. Thus, providers involved on the care of these patients should monitor their blood pressure at all clinic visits.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"307-311"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374345","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":"Rituximab intervention in management of thrombocytopenia in patients with systemic lupus erythematosus: A single centre experience.","authors":"Zeynep Toker Dincer, Beste Acar, Yagmur Ersoy, Ogulcan Karali, Feyza N Azman, Talal Ammar, Serdal Ugurlu","doi":"10.1177/09612033251319395","DOIUrl":"10.1177/09612033251319395","url":null,"abstract":"<p><p>ObjectiveAssessment of the efficacy and safety of rituximab (RTX) in treating thrombocytopenia of systemic lupus erythematosus (SLE) patients unresponsive to conventional treatments, highlighting its potential as an alternative to the expensive intravenous immunoglobulin (IVIG), and investigating the optimal number of RTX cycles for complete remission (CR).MethodsA retrospective analysis was conducted on RTX utilization between 2016 and 2023 at our center. Medical records of SLE patients with thrombocytopenia, resistant to conventional treatments, were reviewed.Results26 patients (21 females, five males) aged 52.1 ± 14.4 years were included. All patients received glucocorticoid (GC) treatment and 12 patients received IVIG before RTX administration. The median number of RTX cycles administered was 2.50 (IQR: 2-6). CR was achieved in 18 patients (69.2%), with 10 (38.5%) attaining CR during the initial treatment cycle. Four patients attained partial remission (PR), and four remained refractory. The median number of cycles needed to achieve CR during follow-up was 1.5 (IQR: 1-3.5). RTX significantly reduced the need for GCs, with only 7.7% of patients receiving prednisolone >5 mg afterward. Additionally, IVIG necessity decreased, with only 19.2% of patients requiring IVIG after completing 6 months of RTX treatment (<i>p</i> < 0.046). The median platelet count significantly increased after RTX treatment (<i>p</i> < 0.001) and the incidence of bleeding decreased from 76.9% to 34.6% after 6 months of RTX treatment, with none classified as life-threatening. No side effects were observed, except for hypogammaglobulinemia in one patient (3.8%).ConclusionRTX demonstrates efficacy and safety for SLE patients with thrombocytopenia unresponsive to conventional treatments, offering a potential alternative, and reducing reliance on GCs and IVIG.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"253-260"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391341","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":"New insights into the long-term adverse effects of antimalarials in patients with systemic lupus erythematosus.","authors":"Olga Araújo, Gerard Espinosa, José Hernández-Rodríguez, Halbert Hernández-Negrín, Alfredo Adán, Laura Pelegrín, Ricard Cervera","doi":"10.1177/09612033251317557","DOIUrl":"10.1177/09612033251317557","url":null,"abstract":"<p><p>BackgroundHydroxychloroquine is recommended for all patients with systemic lupus erythematosus (SLE) because of its efficacy and safety. Previous studies of antimalarial toxicity under non-experimental conditions have often grouped hydroxychloroquine and chloroquine. This study focuses on the long-term toxicity of antimalarial drugs in SLE patients at a single reference centre. The research seeks to identify trends in antimalarial toxicity and determine risk factors contributing to long-term adverse effects.Materials and MethodsRetrospective data were collected from electronic medical records of consecutively diagnosed SLE patients, followed for at least 5 years, from 1998 to 2017. The outcome variable \"antimalarial long-term adverse effect\" was considered if the adverse effect occurred after at least 5 years of continuous antimalarial treatment. Hazard regression analysis was used to identify independent factors associated with long-term antimalarial adverse effects.ResultsThree hundred 22 patients followed for a median of 15 years were analysed. The mean age at SLE diagnosis was 33.4 years, and 91.3% were women. Antimalarial drugs were started in 314 (97.5%) patients. Adverse effects were observed in 55 (17.5%) patients, mainly macular toxicity (11.5%). The incidence of all types of toxicity was higher in the long-term users than in the short-term users (12.1% vs 5.4%; <i>p</i> < .001). Previous use of chloroquine (HR 3; 95%CI 1-9), anti-ß2-glycoprotein antibody positivity (HR 2; 95%CI 1-4) and hydroxychloroquine doses higher than 5 mg/kg/day (HR 2.6; 95%CI 1-7) were identified as independent factors associated with long-term antimalarial toxicity.ConclusionsIn our experience over the past 20 years, almost all SLE patients were treated with antimalarials. Macular toxicity was the most common long-term adverse effect. Patients with previous use of chloroquine, higher than recommended doses of hydroxychloroquine, and positive anti-ß2-glycoprotein antibodies were more likely to develop long-term antimalarial toxicity.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"243-252"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052913","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":"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":"312-315"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","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":"Investigating the role of IL-6 in the pathogenesis of systemic lupus erythematosus: Insights from bone marrow mesenchymal stem cells.","authors":"Zhiwen Zhang, Silang Zhu, Qian Li, Shanshan Wei, Li Yin, Junhao Zhu, Shan Yang, Wenjing Zhang, Kuan Lai","doi":"10.1177/09612033251317783","DOIUrl":"10.1177/09612033251317783","url":null,"abstract":"<p><p>BackgroundSystemic lupus erythematosus is a common autoimmune disease. Studies have suggested that defective stem cells could be involved in the pathogenesis of systemic lupus erythematosus, which leads to changes in the function of immune cells. By observing the cell morphology, autophagy, and senescence of bone marrow mesenchymal stem cells (BMSCs) from lupus mice and normal controls, this study investigated the role of IL-6 in autophagy and senescence of BMSCs and explored relevant mechanisms.MethodFemale MRL/lpr and C57 mice with similar weights and sizes at 20-22 weeks old were selected. BMSCs were isolated using the whole bone marrow adherent method. Quantitative real-time polymerase chain reaction, β-galactosidase staining, western blotting, and ELISA were used to detect autophagy and senescence.ResultCompared with BMSCs from normal mice, BMSCs from lupus mice exhibited low autophagy and premature senescence with a senescence-associated secretory phenotype. The addition of exogenous IL-6 increased the protein levels of p-STAT3 and Bcl-2, and in the IL-6-treated group, the premature senescence of cells increased and autophagy decreased.ConclusionThe biological functions of BMSCs from MRL/lpr lupus mice were impaired. IL-6 prevents autophagy and subsequently promotes the senescence of BMSCs by activating the IL-6/STAT3 pathway.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"225-233"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066497","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":"Laryngeal and voice dysfunction in systemic lupus erythematosus patients - A case-control study.","authors":"Susana P Silva, Carolina Mazeda, Luísa Azevedo, Sandra Augusto, Manuel Viegas, Gisela Eugénio, Anabela Barcelos","doi":"10.1177/09612033251317356","DOIUrl":"10.1177/09612033251317356","url":null,"abstract":"","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"326-327"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066499","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":"Evaluating large language models as a supplementary patient information resource on antimalarial use in systemic lupus erythematosus.","authors":"Pamela Munguía-Realpozo, Claudia Mendoza-Pinto, Ivet Etchegaray-Morales, Edith Ramírez-Lara, Juan Carlos Solis-Poblano, Socorro Méndez-Martínez, Laura Serrano Vertiz, Jorge Ayón-Aguilar","doi":"10.1177/09612033251324501","DOIUrl":"https://doi.org/10.1177/09612033251324501","url":null,"abstract":"<p><strong>Objective: </strong>To assess the accuracy, completeness, and reproducibility of Large Language Models (LLMs) (Copilot, GPT-3.5, and GPT-4) on antimalarial use in systemic lupus erythematosus (SLE).</p><p><strong>Materials and methods: </strong>We utilized 13 questions derived from patient surveys and common inquiries from the National Health Service. Two independent rheumatologists assessed responses from the LLMs using predefined Likert scales for accuracy, completeness, and reproducibility.</p><p><strong>Results: </strong>The GPT models and Copilot achieved high scores in accuracy. However, the completeness of outputs was rated at 38.5%, 55.9%, and 92.3% for Copilot, GPT-3.5, and GPT-4. When questions related to \"mechanism of action\" and \"lifestyle\", were analyzed for completeness (<i>n</i> = 8), ChatGPT-4 scored significantly higher (100%) compared to Copilot (37.5%). In contrast, questions related to \"side-effects\" (<i>n</i> = 5) scored higher for ChatGPT models than Copilot, and the differences were not statistically significant. All three LLMs demonstrated high reproducibility, with rates ranging from 84.6% to 92.3%.</p><p><strong>Conclusions: </strong>Advanced LLMs like GPT -4 offer significant promise in enhancing patients' understanding of antimalarial therapy in SLE. Although chatbots' capability can potentially bridge the information gap patients face, the performance and limitations of such tools need further exploration to optimize their use in clinical settings.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251324501"},"PeriodicalIF":1.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515912","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":"Impact of SARS-CoV-2 pre-delta/delta and omicron variants on clinical outcomes in a systemic lupus erythematosus cohort from Puerto Rico.","authors":"Lilliana Serrano-Arroyo, Ariana González-Meléndez, Rafael Ríos-Rivera, Valeria Rodríguez-González, Luis M Vilá","doi":"10.1177/09612033251325361","DOIUrl":"https://doi.org/10.1177/09612033251325361","url":null,"abstract":"<p><strong>Objective: </strong>To examine the clinical outcomes of systemic lupus erythematosus (SLE) patients with COVID-19 during the Pre-Delta/Delta and Omicron periods.</p><p><strong>Methods: </strong>A retrospective study was conducted in a cohort of adult Puerto Ricans with SLE. Demographic parameters, SLE and COVID-19 manifestations, comorbidities, pharmacologic treatment, SLE exacerbations, hospitalizations, and mortality were determined. SARS CoV-2 infection was confirmed by polymerase chain reaction or antigen tests. Variables were compared between the Pre-delta/Delta and Omicron periods. Also, the proportion of COVID-19 cases and mortality of SLE patients was compared to the general population of Puerto Rico.</p><p><strong>Results: </strong>Of the entire SLE cohort (<i>n</i> = 347), 169 patients (48.7%) had COVID-19. Twenty-two patients had COVID-19 during the Pre-delta/Delta period and 147 during the Omicron period. The proportion of COVID-19 cases in the SLE cohort was significantly higher when compared to the adult general population of Puerto Rico (25.7%), but no difference in mortality was found. Overall, the clinical outcomes of COVID-19 in the SLE cohort were favorable, with low rates of lupus flares (3.0%), hospitalizations (3.6%), and mortality (0.6%). Patients with COVID-19 during the Pre-delta/Delta period were more likely to have oral ulcers, anti-Smith antibodies, and chronic kidney disease, whereas those during the Omicron period were more likely to have COVID-19 symptoms (rhinorrhea, sore throat, and cough).</p><p><strong>Conclusion: </strong>In summary, is this group of Puerto Ricans with SLE, a high proportion had COVID-19, but disease exacerbation, hospitalization, and mortality rates were low. Few clinical differences were noted in SLE patients when comparing the Pre-delta/Delta and Omicron periods.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251325361"},"PeriodicalIF":1.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523864","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":"Illness experience and authorship of life in a \"transplanted person\" with Lupus: A DIPEx perspective.","authors":"Juliano Victor Luna, Marina Assis Pinheiro, Alícia Navarro Dias de Souza","doi":"10.1177/09612033251324498","DOIUrl":"https://doi.org/10.1177/09612033251324498","url":null,"abstract":"<p><p>We present a case of a 37 yo woman who underwent a heart and kidney transplantation due to Lupus and has had a 10-year follow-up without significant complications or Lupus recurrence. Her case was part of a DIPEx International project with heart transplant patients, and we discussed, from a DIPEx perspective, the importance of narrative and illness experience to her recovery. She made a video of various stages of her illness period and was able to regain her sense of life purpose through the narrative resources she developed in her rehabilitation period. We also consider the concept of authorship of life and how the integration of her senses of life purpose and authorship of life have significantly reinforced her resilience and coping mechanisms and may be responsible for her successful outcome in the 10-year milestone of a heart and kidney transplantation.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251324498"},"PeriodicalIF":1.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523863","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":"Infant feeding experiences of women with systemic lupus erythematosus: A qualitative study.","authors":"Sarah B Lieber, Bessie C Stamm, Sarah R Young, Jillian Rose-Smith, Juliette Kleinman, Amaya Smole, JoAnn Vega, Caroline H Siegel, Medha Barbhaiya, Lisa A Mandl, Michael D Lockshin, Lisa R Sammaritano","doi":"10.1177/09612033251324493","DOIUrl":"10.1177/09612033251324493","url":null,"abstract":"<p><strong>Background/objective: </strong>Although breastfeeding is safe in women with systemic lupus erythematosus (SLE) who take breastfeeding-compatible medications, rates of breastfeeding are inconsistent, and little is known about the lived experiences surrounding infant feeding among women with SLE. In this qualitative study, we identified factors that influence infant feeding practices of these women.</p><p><strong>Methods: </strong>Using a phenomenological approach, we conducted and thematically analyzed semi-structured interviews on infant feeding practices with adult women with SLE evaluated at a single tertiary care musculoskeletal center who had given birth within the last 6 years. We collected and summarized maternal, SLE disease, and pregnancy characteristics using descriptive statistics.</p><p><strong>Results: </strong>Semi-structured interviews were conducted among 19 women with SLE with mean age of 36.1 years at delivery. We identified four overarching themes: general considerations related to infant feeding, medical considerations related to infant feeding, perspectives on infant feeding, and messages to peers with SLE and healthcare providers.</p><p><strong>Conclusions: </strong>We identified both SLE-specific and disease-agnostic factors impacting infant feeding behaviors in women with SLE. SLE-specific factors influencing infant feeding practices should be viewed holistically within the context of individuals' personal preferences, which in turn may be shaped by interpersonal and cultural factors. Our findings can inform shared decision-making related to infant feeding practices in women with SLE, as well as tailored educational strategies to meet their unique needs.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251324493"},"PeriodicalIF":1.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523866","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}