Lupus最新文献

{"title":"Acceptability and impact of a lifestyle intervention for systemic lupus erythematosus: Qualitative analysis of living well with lupus study.","authors":"Bruna Caruso Mazzolani, Fabiana Infante Smaira, Sofia Mendes Sieczkowska, Marina Romero, Heloísa C Santo André, Sandra G Pasoto, Ana Lúcia de Sá Pinto, Fernanda Rodrigues Lima, Fabiana Braga Benatti, Hamilton Roschel, Mary Beth Weber, Bruno Gualano","doi":"10.1177/09612033251326986","DOIUrl":"10.1177/09612033251326986","url":null,"abstract":"<p><p>Despite the beneficial effects of a healthier lifestyle, lack of more robust data hampers standardization of recommendations for patients with systemic lupus erythematosus (SLE). Thus, this study explores the experiences, perceptions, and health effects of a newly developed healthy lifestyle intervention in patients with SLE. This was a qualitative, descriptive study using focus group discussions with SLE patients with high cardiovascular risk who participated in a 6-month behavioral lifestyle intervention versus standard of care randomized controlled trial. The intervention group received the Living Well with Lupus (LWWL) program aimed at changing lifestyle behaviors. Focus groups were composed of 4-6 LWWL participants each. Deductive and inductive qualitative content analysis was performed using the MAXQDA data management software. A thematic analysis was conducted wherein thick descriptions of key themes around SLE patients' perceptions related to the intervention and interventions' effects on routine, health-related outcomes and well-being were developed. 19 patients participated in the focus groups (age: 42 ± 7 years; BMI: 28.3 ± 2.4 kg/m²; mild disease activity and organ damage index). Overall, (a) participants were mostly positive about the intervention components, although views of home-based exercise and food diaries were both positive and negatives; (b) barriers and facilitators to intervention adherence included socioeconomic, environmental and individual factors; (c) new behaviors and knowledge were achieved, which participants intended to maintain after the study; and (d) the intervention positively impacted daily functioning, physical and mental health, and overall wellbeing. LWWL participants reported success in achieving healthy lifestyle behaviors in addition to improvements in perceived physical and mental health and overall wellbeing during the LWWL program. Results of this qualitative assessment, including an overview of barriers and facilitators to program initiation and adherence, should guide future research on the implementation of lifestyle interventions in SLE care.Clinicaltrials.govNCT04431167.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"474-483"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625422","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":"Serum CXCL-13 levels are associated with active neurological involvement in patients with systemic lupus erythematosus.","authors":"Derya Yildirim, Abdulsamet Erden, Antonis Fanouriakis, Handenur Koc Kanik, Hakan Babaoglu, Riza Can Kardas, Burcugul Kaya, Ibrahim Vasi, Rahime Duran, Hazan Karadeniz, Hamit Kucuk, Berna Goker, Mehmet Akif Ozturk, Abdurrahman Tufan","doi":"10.1177/09612033251319405","DOIUrl":"10.1177/09612033251319405","url":null,"abstract":"<p><p><b>Background:</b> Systemic lupus erythematosus (SLE) is an autoimmune disease with diverse systemic manifestations, including neuropsychiatric involvement (NPSLE), which can vary in severity and prognosis. Diagnosing NPSLE remains challenging, necessitating reliable diagnostic markers. CXCL13, a B-cell chemokine implicated in SLE, has garnered attention for its potential role in NPSLE.<b>Purpose:</b> This study aimed to assess serum CXCL-13 levels in NPSLE patients compared to SLE patients without neuropsychiatric symptoms and healthy controls.<b>Research Design:</b> All study groups were studied CXCL-13 levels from blood samples.<b>Study Sample:</b> One hundred twenty-five participants were categorized into four groups: SLE patients with active NPSLE (<i>n</i> = 6), SLE patients with inactive NPSLE (<i>n</i> = 26), SLE patients without NPSLE (<i>n</i> = 71), and healthy controls (<i>n</i> = 22).<b>Data Collection and Analyses:</b> Serum samples were collected at the time of enrollment and CXCL-13 levels were analysed by Enzyme Linked ImmunoSorbent Assay (ELISA) method.<b>Results:</b> Results indicated significantly elevated CXCL-13 levels in active NPSLE patients compared to other SLE patient groups and healthy controls (<i>p</i> < 0.001 for all). Patients with SLE, including those with inactive NPSLE or no history of NPSLE, had statistically significantly higher serum CXCL-13 levels compared to the control group (<i>p</i> < 0.001). Additionally, serum CXCL-13 levels positively correlated with disease activity assessed by the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI).<b>Conclusion:</b> This study underscores the association between serum CXCL-13 levels and neuropsychiatric involvement in SLE, as well as their correlation with disease activity. Moreover, previous research suggesting a link between CXCL-13 levels and clinical activity in SLE further supports its potential as a diagnostic marker for NPSLE. Nevertheless, further investigations are warranted to validate the utility of CXCL-13 as a diagnostic tool for NPSLE and its role in disease management.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"281-291"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365235","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":"The impact of white matter brain lesions on processing speed deficits in systemic lupus erythematosus patients.","authors":"Anna Wójcicka-Frankiewicz, Mikołaj A Pawlak, Maciej Piernik, Maria Forycka, Monika Wiłkość-Dębczyńska, Ewa Więsik-Szewczyk, Katarzyna Pawlak-Buś, Piotr Leszczyński, Sławomir Michalak, Aleksandra Wypych, Zbigniew Serafin, Wojciech Kozubski, Alicja Kalinowska-Łyszczarz","doi":"10.1177/09612033251319826","DOIUrl":"10.1177/09612033251319826","url":null,"abstract":"<p><p>BackgroundThe mechanism of cognitive dysfunction in systemic lupus erythematosus (SLE) is still not fully understood. Even though many SLE patients present some neurological dysfunction, including various cognitive deficits, neither a specific pattern of cognitive dysfunction nor specific structural changes associated with cognitive impairment in SLE patients have been established. Moreover, although prevalent and bothersome, cognitive deficits have not been included in the most recent SLE diagnostic criteria.PurposeThe aim of this study was to determine the relationship between the presence of white matter lesions (WMLs) and cognitive dysfunction in patients diagnosed with SLE.Research Design33 SLE patients underwent 3 T brain magnetic resonance imagining (MRI) and an extensive battery of psychological tests, including Automated Neuropsychological Assessment Metrics (ANAM) and the standard pen and paper neuropsychological tests. Patients were stratified into two groups based on the presence (<i>N</i> = 15) or absence (<i>N</i> = 18) of WMLs. Psychometric scores were compared between the two groups.Results and conclusionsSignificant deficits in cognitive functions were observed. Patients with WMLs showed deficits in attention and executive functions, as well as memory deficits in comparison to the group without WMLs. As measured with: STROOP Test (executive function), Color Trail Test (CTT) (attention), Californian Verbal Learning Test (CVLT) (memory), and from ANAM tests with: Procedural Reaction Time (PRT) (attention), Code Substitution Delayed (CS_D) (memory), Spatial Processing (SP) (visuospatial functions), Tower Puzzle (TP) (executive functions), 2 Choice Reaction Time (2CHRT) (attention), Running Memory CPT (RM CPT) (memory), Matching Grids (Mat GR) (visuospatial functions), Go/No _Go inhibition (Go/No_Go Go) (executive functions). Additionally, we analyzed structural volumetric measures derived from a comprehensive segmentation pipeline recon-all using Freesurfer 5.3. Significant differences were identified for the following structures' volumes: right choroid plexus, left choroid plexus, right lateral ventricle. All these structures had a greater volume in patients with WMLs.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"270-280"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382810","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":"Systematic literature review of intravenous immunoglobulin use in non-renal and non-hematologic systemic lupus erytehmatosus.","authors":"Cristina Primo-Gabriel, Carmen García-Gómez, Jaime Calvo-Alén","doi":"10.1177/09612033251319402","DOIUrl":"10.1177/09612033251319402","url":null,"abstract":"<p><p><b>Objective</b>: Intravenous immunoglobulins (IVIG) are an established treatment in several immune-mediated diseases such as dermatomyositis or Kawasaki disease and they have been used in distinct clinical scenarios in systemic lupus erythematosus (SLE). However, in this latter disease no clear evidence besides hematological or renal involvement supports its use. The aim of the present study is to establish evidence for the treatment of non-renal non-hematological lupus with IVIG.<b>Methods</b>: We have carried out a systematic literature review following PRYSMA principles on the use of this treatment in SLE patients with no renal no hematologic manifestations.<b>Results</b>: We found 35 articles which were split into two subtypes, those with individualized data (29) and those with grouped data. Overall, 198 lupus patients treated with IVIGs [178 (90%) women and 20 (10%) men] were included. In 167 (84.3%) a clinical response was obtained [62 (31.3%) complete and 105 (53%) a partial one]. Adverse events were reported in 40 patients (20.2%), most of them mild with only 2 (1%) severe. According to individualized data, all cases with respiratory problems (5), 82.4% of those with cardiac involvement (18) and 53.8% of those with neuropsychiatric manifestations (18) achieved a complete response as more outstanding results.<b>Conclusions</b>: After reviewing the experience of the use of IVIGs in extra-renal and extra-hematologic SLE patients, this treatment is demonstrated to be useful in refractory cases, especially in pulmonary, cardiac or neuropsychiatric complications with a good safety profile.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"261-269"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365236","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":"Nocardiosis in systemic lupus erythematosus patients treated with rituximab: Report of two cases and systematic review of literature.","authors":"Jaime Gil-Rodríguez, Javier de la Hera Fernández, Michel Martos Ruiz, Raquel Ríos Fernández, Marta García Morales, José-Luis Callejas-Rubio","doi":"10.1177/09612033251319836","DOIUrl":"10.1177/09612033251319836","url":null,"abstract":"<p><p>BackgroundThe relationship between systemic lupus erythematosus (SLE) patients treated with rituximab and nocardiosis remains unclear.Cases ReportA 55-year-old female with lupus nephritis II and smoking history, was treated with high-dose steroids, immunoglobulins, rituximab, and azathioprine. She developed infectious loci in the lungs, hip, and brain. N. farcinica was detected in bronchoalveolar lavage and abscess culture. She was treated with linezolid, trimethoprim/sulfamethoxazole (TMP/SMX), minocycline, and amoxicillin/clavulanic acid, achieving complete cure at 12 months. The second patient, a 73-year-old male with lupus nephritis V, autoimmune thrombocytopenia, antiphospholipid syndrome (APS), and alveolar hemorrhage, was treated with high-dose steroids, azathioprine, mycophenolate, and rituximab. He developed infections in the lungs, prostate, and possibly colon. N. farcinica was detected in blood cultures. Despite treatment with imipenem, linezolid, TMP/SMX, and moxifloxacin, he died from bronchoaspiration.MethodsA systematic review was conducted using PubMed, Embase, Web of Science, and Scopus. The search terms were (systemic lupus erythematosus OR SLE) AND (rituximab) AND (nocardia), with a timeframe up to 15 March 2024. Inclusion criteria were confirmed cases of Nocardia infection in SLE patients treated with rituximab in the previous year. Non-original studies and secondary research were excluded.ResultsOnly one article was included, describing a 34-year-old male with APS and lupus nephritis IV, treated with high-dose steroids, cyclophosphamide, and rituximab. He had infections in the lungs and brain, with N. farcinica detected in blood cultures. Despite treatment with TMP/SMX and fluoroquinolones, he died from thrombotic complications.ConclusionNocardiosis is more likely in SLE patients due to T lymphocyte immune dysfunction caused by the disease itself, rituximab, and other immunosuppressants. Diagnosis requires a high level of clinical suspicion, supported by long-time blood cultures and 16S rRNA. Beta-lactams and quinolones are reasonable alternatives to TMP/SMX and linezolid, which can worsen the hematological situation, and amikacin, which may worsen lupus nephritis.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"316-325"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515915","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":"Insertion/deletion polymorphism of the angiotensin-converting enzyme gene in lupus nephritis at Cho Ray hospital, Vietnam.","authors":"Anh N L Nguyen, Anh T Le, Vincent W S Lee, Huong T B Tran","doi":"10.1177/09612033251317346","DOIUrl":"10.1177/09612033251317346","url":null,"abstract":"<p><p><b>Introduction:</b> The pathogenesis for poor kidney outcomes in lupus nephritis (LN) remains uncertain. There is limited evidence on the association between angiotensin-converting enzyme <i>(ACE) I/D</i> polymorphism and LN with kidney failure. <b>Objectives:</b> To determine the distribution of <i>ACE I/D</i> alleles and genotypes and the correlation between ACE I/D polymorphism and kidney outcomes in LN participants. <b>Subjects and Methods:</b> A cross sectional study was conducted at Cho Ray Hospital (12/2021-07/2023). The LN participants were stratified into 3 groups based on the kidney function and kidney replacement therapy (KRT) on admission. The <i>ACE I/D</i> polymorphism was identified by the polymerase chain reaction. <b>Results:</b> Among 208 LN participants, 71 were in group 1 (eGFR > 60), 55 in group 2 (eGFR ≤ 60 without KRT), 82 in group 3 (eGFR ≤ 60 with KRT). The skewed distribution among 3 groups were observed in <i>D</i> allele (20.4%, 35.5%, 37.2% in group 1, 2, 3, respectively, <i>p</i> = .003) and <i>DD</i> genotype (2.8%, 14.6%, 12.2% in group 1, 2, 3, respectively, <i>p</i> = .005). The <i>ID/DD</i> genotypes increased the susceptibility of kidney failure (eGFR ≤ 60 vs eGFR > 60: OR = 8.26 for <i>DD</i> genotype, OR = 2.31 for <i>ID</i> genotype) and KRT (KRT vs no KRT: OR = 2.01 for <i>ID</i> genotype). <b>Conclusions:</b> The <i>D</i> allele and <i>ID/DD</i> genotypes are linked with the susceptibility of kidney failure in LN participants.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"300-306"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189744","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":"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":"10.1177/09612033251315976","url":null,"abstract":"<p><p>BackgroundGlucocorticoids 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.PurposeThe aim of this study was to determine risk factors associated with the development of SID in patients with LN.Research Design A nested case-control study was conducted.Study sampleWe included patients with biopsy-proven LN, who received induction treatment with steroids.Data Collection and/or AnalysisOut of the total of 358 patients, 35 (9.7%) developed SID.ResultsPatients 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).ConclusionsIn 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":"234-242"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","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":"Autoantibody clusters in childhood-onset systemic lupus erythematosus: Insights from a multicenter study with 912 patients.","authors":"Vitor C Trindade, Eloisa Bonfá, Ana P Sakamoto, Maria T Terreri, Nádia E Aikawa, Fernanda J Fiorot, Ana C Pitta, Verena A Balbi, Carlos N Rabelo, Marco F Silva, Aline G Islabão, Glaucia V Novak, Katia T Kozu, Izabel M Buscatti, Lucia M Campos, Adriana Me Sallum, Ana P Assad, Claudia S Magalhães, Roberto Marini, Adriana R Fonseca, Flavio R Sztajnbok, Maria C Santos, Blanca E Bica, Evaldo G Sena, Ana J Moraes, Teresa C Robazzi, Paulo F Spelling, Iloite M Scheibel, Andre S Cavalcanti, Erica N Matos, Luciano J Guimarães, Flavia P Santos, Luciana M Carvalho, Magda Carneiro-Sampaio, Alexandre A Ferraro, Clovis A Silva","doi":"10.1177/09612033251317357","DOIUrl":"10.1177/09612033251317357","url":null,"abstract":"<p><p><b>Objective:</b> To identify clusters of autoantibodies in a large cSLE population and to verify possible associations between different autoantibody clusters and the following variables: demographic data, cumulative clinical and laboratory manifestations, disease activity, cumulative damage and mortality. <b>Methods:</b> A cross-sectional study was performed in 27 Pediatric Rheumatology University centers, including 912 cSLE patients. The frequencies of seven selected autoantibodies (anti-dsDNA, anti-Ro/SSA, anti-La/SSB, anti-Sm, anti-RNP, aCL IgM and/or IgG and LA) were used for cluster analysis using the K-means method. <b>Results:</b> Four distinctive antibody clusters were identified. Cluster 1 (<i>n</i> = 322; 35.31%) was characterized by anti-dsDNA (61.18%), low frequency of antiphospholipid antibodies (<10%), and lower frequency of cutaneous, articular manifestation (<i>p</i> < 0.05) and hypocomplementemia (<i>p</i> < 0.001) compared to the other groups. Cluster 2 (<i>n</i> = 158; 17.32%) comprised anti-dsDNA (93.04%), aCL (87.34%) and LA (39.87%) and higher frequencies of thrombocytopenia (<i>p</i> = 0.006) and antiphospholipid syndrome (<i>p</i> < 0.001) than the other clusters. Cluster 3 (<i>n</i> = 177; 19.41%) was characterized by anti-dsDNA (81.36%), anti-Sm (100%) and anti-RNP (44.63%) antibodies, as well as a higher frequency of proteinuria compared to cluster 4 (58.15% vs 56.13% vs 64.00% vs 49.80%, <i>p</i> = 0.031). Cluster 4 (<i>n</i> = 255; 27.96%) consisted of all 7 autoantibodies, with predominance of anti-dsDNA (72.55%), anti-Ro/SSA (89.8%) and anti-La/SSB (45.88%), with no specific clinical pattern, except by higher pulmonary damage (<i>p</i> = 0.017). <b>Conclusions:</b>Our study suggests that, within the context of cSLE, the coexistence of anti-dsDNA with antiphospholipid autoantibodies is linked to an elevated incidence of antiphospholipid syndrome. This association does not coincide with a proportionate increase in the occurrence of nephritis. Conversely, the cluster of anti-dsDNA with anti-Ro/SSA and anti-La/SSB antibodies was associated with pulmonary damage, requiring close surveillance.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"292-299"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052907","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":"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}