Ambika Gupta, Sindhu Johnson, Michelle Barraclough, Jiandong Su, Kathleen Bingham, Andrea M Knight, Juan Pablo Diaz Martinez, Mahta Kakvan, Maria Carmela Tartaglia, Lesley Ruttan, Sherief Marzouk, Joan Wither, May Choi, Dennisse Bonilla, Simone Appenzeller, Dorcas Beaton, Patricia Katz, Robin Green, Zahi Touma
{"title":"Outcome clusters and their stability over 1 year in patients with SLE: self-reported and performance-based cognitive function, disease activity, mood and health-related quality of life.","authors":"Ambika Gupta, Sindhu Johnson, Michelle Barraclough, Jiandong Su, Kathleen Bingham, Andrea M Knight, Juan Pablo Diaz Martinez, Mahta Kakvan, Maria Carmela Tartaglia, Lesley Ruttan, Sherief Marzouk, Joan Wither, May Choi, Dennisse Bonilla, Simone Appenzeller, Dorcas Beaton, Patricia Katz, Robin Green, Zahi Touma","doi":"10.1136/lupus-2023-001006","DOIUrl":"10.1136/lupus-2023-001006","url":null,"abstract":"<p><strong>Objective: </strong>To determine if self-reported fatigue, anxiety, depression, cognitive difficulties, health-related quality of life, disease activity scores and neuropsychological battery (NB) cluster into distinct groups in patients with SLE based on symptom intensity and if they change at 1-year follow-up.</p><p><strong>Methods: </strong>This is a retrospective analysis of consecutive consenting patients, followed at a single centre. Patients completed a comprehensive NB, the Beck Anxiety Inventory, Beck Depression Inventory, Fatigue Severity Scale, Short-Form Health Survey Physical Component Summary and Mental Component Summary scores and the Perceived Deficits Questionnaire. Disease activity was assessed by Systemic Lupus Erythematosus Disease Activity Index 2000. Ward's method was used for clustering and principal component analysis was used to visualise the number of clusters. Stability at 1 year was assessed with kappa statistic.</p><p><strong>Results: </strong>Among 142 patients, three clusters were found: <i>cluster 1</i> had mild symptom intensity, <i>cluster 2</i> had moderate symptom intensity and <i>cluster 3</i> had severe symptom intensity. At 1-year follow-up, 49% of patients remained in their baseline cluster. The mild cluster had the highest stability (77% of patients stayed in the same cluster), followed by the severe cluster (51%), and moderate cluster had the lowest stability (3%). A minority of patients from mild cluster moved to severe cluster (19%). In severe cluster, a larger number moved to moderate cluster (40%) and fewer to mild cluster (9%).</p><p><strong>Conclusion: </strong>Three distinct clusters of symptom intensity were documented in patients with SLE in association with cognitive function. There was a lower tendency for patients in the mild and severe clusters to move but not moderate cluster over the course of a year. This may demonstrate an opportunity for intervention to have moderate cluster patients move to mild cluster instead of moving to severe cluster. Further studies are necessary to assess factors that affect movement into moderate cluster.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"11 2","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11243126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141590697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Real-world effectiveness of belimumab in patients with lupus in China: RELIABLE observational cohort study protocol.","authors":"Liya Fan, Zhiliu Tang, Xin He, Xintong He, Zhuoli Zhang, Patricia Juliao","doi":"10.1136/lupus-2024-001144","DOIUrl":"10.1136/lupus-2024-001144","url":null,"abstract":"<p><strong>Introduction: </strong>The efficacy of belimumab in SLE has been demonstrated in randomised clinical trials, and its real-world effectiveness has been shown in studies in several countries. While belimumab was approved for treating SLE in China in 2019, data on its benefit in clinical practice are limited. This study will evaluate belimumab's effectiveness in China, using practical clinical measures, such as Lupus Low Disease Activity State (LLDAS), to add to the body of real-world evidence.</p><p><strong>Methods and analysis: </strong>The Real-world Effectiveness of beLImumAB in patients with systemic Lupus Erythematosus in China (RELIABLE) is an ambidirectional, observational descriptive cohort study across approximately 15 centres in China. Adults with SLE newly initiating belimumab with ≥1 measure of all five LLDAS components (SLE Disease Activity Index-2000; no new lupus disease activity; Physician Global Assessment; prednisolone-equivalent dose; immunosuppressants/biologics use) in the 3 months preceding belimumab initiation (index date) will be eligible and retrospectively and/or prospectively enrolled, depending on data availability. The retrospective follow-up will be ≤6 months, and retrospective and prospective patients will have a maximum 24-month follow-up. The primary objectives will be to describe the proportion of patients achieving LLDAS at 12 and 24 months post-index. The key secondary objective will be to describe the proportion of patients achieving LLDAS and each component at 3, 6, 9 and 18 months post-index. All data will be analysed descriptively; a statistical estimand will be applied to account for intercurrent events expected in a real-world setting.</p><p><strong>Ethics and dissemination: </strong>This study will comply with all applicable laws regarding patient privacy; institutional review board approval will be obtained before the study commencement.</p><p><strong>Conclusions: </strong>This study will evaluate belimumab's effectiveness in patients with SLE initiating belimumab in clinical practice in China. Using LLDAS will provide clinicians with valuable insights into the impact of belimumab on the treat-to-target strategy with a relevant measure that can be repeated across the clinical practice.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"11 2","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11243130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141590698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Antiplatelet effects of hydroxychloroquine in patients with systemic lupus erythematosus evaluated by the total thrombus-formation analysis system (T-TAS).","authors":"Daisuke Hiraoka, Jun Ishizaki, Jun Yamanouchi, Takatsugu Honda, Toshiyuki Niiya, Erika Horimoto, Kenta Horie, Hitoshi Yamasaki, Takuya Matsumoto, Koichiro Suemori, Hitoshi Hasegawa, Katsuto Takenaka","doi":"10.1136/lupus-2024-001223","DOIUrl":"10.1136/lupus-2024-001223","url":null,"abstract":"<p><strong>Objectives: </strong>Hydroxychloroquine (HCQ) has been shown to reduce thrombotic events in patients with SLE. However, the antiplatelet effects of HCQ are only supported by the platelet aggregation assay, which is a non-physiological test. The total thrombus-formation analysis system (T-TAS) is a microchip-based flow chamber system that mimics physiological conditions and allows for the quantitative analysis of thrombogenicity. The present study investigated the antiplatelet effects of HCQ using T-TAS.</p><p><strong>Methods: </strong>This was a single-centre cross-sectional study on 57 patients with SLE. We measured the area under the pressure curve for 10 min (PL-AUC<sub>10</sub>) and the time to 10 kPa (T<sub>10</sub>) in patients with SLE using T-TAS and examined their relationships with the use of HCQ. PL-AUC<sub>10</sub> and platelet aggregation were also measured at several HCQ concentrations using blood samples from healthy donors.</p><p><strong>Results: </strong>PL-AUC<sub>10</sub> was significantly lower in the HCQ/real body weight (RBW) ≥5 mg/kg group than in the <5 mg/kg group, while T<sub>10</sub> was similar, indicating that HCQ inhibited overall thrombus formation rather than the initiation of thrombus formation. The antiplatelet effects of HCQ were initially detected at HCQ/RBW of approximately 4 mg/kg and reached a plateau at around 5.5 mg/kg. The administration of HCQ/RBW >4.6 mg/kg clearly exerted antiplatelet effects. Additionally, HCQ inhibited thrombus formation in T-TAS and the platelet aggregation response to epinephrine in a dose-dependent manner.</p><p><strong>Conclusions: </strong>We demonstrated the antiplatelet effects of HCQ under conditions simulating the physiological environment by using T-TAS and identified the range of doses at which HCQ exerted antiplatelet effects.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"11 2","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11256038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jessica Ellis, Neil McHugh, John D Pauling, Ian N Bruce, Rachel Charlton, Anita McGrogan, Sarah Skeoch
{"title":"Changes in the incidence and prevalence of systemic lupus erythematosus between 1990 and 2020: an observational study using the Clinical Practice Research Datalink (CPRD)","authors":"Jessica Ellis, Neil McHugh, John D Pauling, Ian N Bruce, Rachel Charlton, Anita McGrogan, Sarah Skeoch","doi":"10.1136/lupus-2024-001213","DOIUrl":"https://doi.org/10.1136/lupus-2024-001213","url":null,"abstract":"Objective To obtain updated estimates on the incidence and prevalence of systemic lupus erythematosus (SLE) in the UK, over the period 1990–2020, using the Clinical Practice Research Datalink (CPRD). Methods This was a retrospective cohort study using the CPRD covering the period 1990–2020. A case ascertainment algorithm was developed in line with best practice recommendations for observational research. Incidence was calculated per 100 000 person-years and point prevalence (at the mid-year point) calculated per 100 000. Results were stratified by sex. Results 9443 SLE cases were identified. 5278 incident cases were identified (4538 women, 740 men). The overall incidence rate was 5.47 (95% CI 5.33 to 5.62) cases per 100 000 person-years. Incidence rates decreased slightly across the study period, which was more pronounced for women than men. Point prevalence increased over time, from 21.4 (95% CI 17.68 to 25.67) per 100 000 in 1990 to 107.14 (95% CI 103.26 to 111.12) per 100 000 in 2020. Conclusions The observed fivefold increase in prevalence of SLE over the last 30 years, in the context of a modest decline in incidence rate, may suggest improved outcomes in SLE and has important implications for healthcare service delivery and planning in the UK. Data are available upon reasonable request. The data underlying this article were provided by Clinical Practice Research Datalink under license. Available data will be shared on request to the corresponding author with permission of the Clinical Practice Research Datalink.","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"27 1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141785307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fatma El Hadiyen, Michel W P Tsang-A-Sjoe, Birgit I Lissenberg-Witte, Alexandre E Voskuyl, Irene E M Bultink
{"title":"Intercurrent infection as a risk factor for disease flares in patients with systemic lupus erythematosus.","authors":"Fatma El Hadiyen, Michel W P Tsang-A-Sjoe, Birgit I Lissenberg-Witte, Alexandre E Voskuyl, Irene E M Bultink","doi":"10.1136/lupus-2023-001131","DOIUrl":"10.1136/lupus-2023-001131","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether intercurrent infections are a risk factor for subsequent disease flares in systemic lupus erythematosus (SLE).</p><p><strong>Methods: </strong>Demographic and clinical characteristics of 203 patients with SLE participating in the Amsterdam SLE cohort were collected at baseline and during follow-up. Collection of data on infections and SLE flares was registry-based and infections and flares were categorised as minor or major, based on predefined criteria. Proportional hazard models with recurrent events and time-varying covariates were used to estimate the HR of SLE flares.</p><p><strong>Results: </strong>The incidence rates of major and minor infections were 5.3 per 100 patient years and 63.9 per 100 patient years, respectively. The incidence rates of flares were 3.6 and 15.1 per 100 patient years for major flares and minor flares, respectively.In the proportional hazard model, intercurrent infections (major and minor combined) were associated with the occurrence of SLE flares (major and minor combined; HR 1.9, 95% CI: 1.3 to 2.9). The hazard ratio for a major SLE flare following a major infection was 7.4 (95% CI: 2.2 to 24.6). Major infections were not associated with the occurrence of minor flares.</p><p><strong>Conclusions: </strong>The results of the present study show that intercurrent infections are associated with subsequent SLE flares, which supports the hypothesis that infections may trigger SLE flares.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"11 2","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11217993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141492479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Katrina Guardino, Malaya Gaerlan, Caitlan S Pinotti, Kimberly R Burnett, Deborah Kofoed, Laura Eve Schanberg, Lisa B Hightow-Weidman, Rachel L Randell
{"title":"Meeting report: patient and caregiver recommendations for a mobile health application for paediatric systemic lupus erythematosus","authors":"Katrina Guardino, Malaya Gaerlan, Caitlan S Pinotti, Kimberly R Burnett, Deborah Kofoed, Laura Eve Schanberg, Lisa B Hightow-Weidman, Rachel L Randell","doi":"10.1136/lupus-2024-001305","DOIUrl":"https://doi.org/10.1136/lupus-2024-001305","url":null,"abstract":"Paediatric systemic lupus erythematosus (pSLE) management and research could be enhanced by a mobile health application (app); however, no app designed for pSLE is currently available. A development and design committee comprising of patients, parents/caregivers and other stakeholders met to inform development and design of an app specific for pSLE. This meeting report summarises the group’s discussions and recommendations that could help create a useful and desirable app or mobile health tool for the pSLE community.","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"24 1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141871711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lin Peng, Pengcheng Wang, Xiaodong Xu, Dacheng Chen, Feng Xu, Fan Yang, Shuying Yang, Hongguang Xia, Zhi-Hong Liu, Weisong Qin
{"title":"Inhibition of receptor interacting protein kinase-1 (RIPK1) in the treatment of murine lupus.","authors":"Lin Peng, Pengcheng Wang, Xiaodong Xu, Dacheng Chen, Feng Xu, Fan Yang, Shuying Yang, Hongguang Xia, Zhi-Hong Liu, Weisong Qin","doi":"10.1136/lupus-2024-001146","DOIUrl":"10.1136/lupus-2024-001146","url":null,"abstract":"<p><strong>Objective: </strong>Systemic lupus erythematosus (SLE) is a type of autoimmune disease that involves multiple organs involved as well as cytokine dysregulation. The treatment of SLE is still challenging due to the side effects of the different drugs used. Receptor-interacting protein kinase 1 (RIPK1) is a kinase involved in T cell homeostasis and autoinflammation. Although clinical trials have shown that RIPK1 inhibition exhibits significant efficacy in different autoimmune diseases, its role in SLE remains unclear.</p><p><strong>Methods: </strong>MRL/lpr lupus-prone mice received RIPK1 inhibitor ZJU37 or vehicle intraperitoneally for 10 weeks. A BM12-induced chronic graft-versus-host-disease (cGVHD) lupus-like model was introduced in RIPK1 D138N mice or C57BL/6 mice. Nephritis, serum autoantibody levels, dysregulation of adaptive immune response and cytokines were compared in treated and untreated mice.</p><p><strong>Results: </strong>ZJU37 alleviated the clinical features of the MRL/lpr mice including nephritis and anti-dsDNA antibody production. In addition, ZJU37 treatment reduced the proportion of double-negative T cells in the spleen and the cytokines of TNFα, IFN-γ, IL-6, IL-17 and IL-1β in the serum. Moreover, RIPK1 D138N mice were able to prevent the cGVHD lupus-like model from SLE attack, manifesting as anti-dsDNA antibody production, the proliferation of germinal centre B cells, plasma cells, and T follicular helper cells as well as IgG and C3 deposits in kidneys.</p><p><strong>Conclusion: </strong>RIPK1 inhibition has a protective effect in the mouse model of SLE and can potentially become a new therapeutic target for SLE in humans.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"11 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11191810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141437117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Coziana Ciurtin, Junjie Peng, Yiming Gao, Misato Niwa, Stacy P Ardoin, Laura Eve Schanberg, Laura Lewandowski, Elizabeth C Jury, George A Robinson
{"title":"Investigation of the performance of validated cardiovascular risk scores in a global (UK/US) cohort of young people with childhood-onset systemic lupus erythematosus.","authors":"Coziana Ciurtin, Junjie Peng, Yiming Gao, Misato Niwa, Stacy P Ardoin, Laura Eve Schanberg, Laura Lewandowski, Elizabeth C Jury, George A Robinson","doi":"10.1136/lupus-2024-001194","DOIUrl":"10.1136/lupus-2024-001194","url":null,"abstract":"","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"11 1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11177662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141317579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jinlu Ma, Lin Zhang, Mengxue Yan, Zhichun Liu, Leixi Xue
{"title":"Value of SLE-DAS in assessing disease activity in patients with systemic lupus erythematosus: a single-centre retrospective study.","authors":"Jinlu Ma, Lin Zhang, Mengxue Yan, Zhichun Liu, Leixi Xue","doi":"10.1136/lupus-2024-001196","DOIUrl":"10.1136/lupus-2024-001196","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the clinical value of the Systemic Lupus Erythematosus Disease Activity Score (SLE-DAS) for assessing disease activity in patients with SLE.</p><p><strong>Methods: </strong>Clinical data were collected from patients with SLE who were admitted at the Second Affiliated Hospital of Soochow University from January 2009 to December 2022. The glucocorticoid dose grading was used as the gold standard for disease activity assessment in SLE. The SLE-DAS value was calculated, and the SLE disease activity status was graded based on the SLE-DAS value. Another scoring criterion, the SLE Disease Activity Index 2000 (SLEDAI 2000), served as a control. Spearman correlation analysis was used to calculate the correlation between the scoring criteria and other variables.</p><p><strong>Results: </strong>The analysis included 396 patients with SLE. A strong correlation was found between SLE-DAS and SLEDAI 2000 (ρ=0.709, 95% CI 0.648 to 0.766, p<0.001), with median SLE-DAS and SLEDAI 2000 scores of 15.32 (7.90 to 24.45) and 13 (8 to 19), respectively. Compared with the SLEDAI 2000 value, the SLE-DAS value correlated better with glucocorticoid dose grading (ρ=0.434 vs 0.518), gammaglobulin use (ρ=0.170 vs 0.318) and immunosuppressant use (ρ=0.122 vs 0.221). A moderate correlation based on disease activity grading was found between SLE-DAS and glucocorticoid dose grading (ρ=0.441), whereas a mild correlation was observed between SLEDAI 2000 and glucocorticoid dose grading (ρ=0.325). Additionally, SLE-DAS revealed a positive correlation with severe thrombocytopenia, cardiac involvement and pulmonary involvement but not SLEDAI 2000.</p><p><strong>Conclusion: </strong>Compared with SLEDAI 2000, SLE-DAS may provide a more accurate disease activity assessment in patients with SLE, especially those with severe thrombocytopenia and cardiopulmonary involvement.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"11 1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11168181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Multidisciplinary re-evaluation of neuropsychiatric events to confirm the neuropsychiatric lupus diagnosis at an Indonesian tertiary hospital.","authors":"Riwanti Estiasari, Syairah Banu, Alvina Widhani, Fitri Octaviana, Kartika Maharani, Tiara Aninditha, Muthia Huda Islami, Darma Imran, Diatri Nari Lastri","doi":"10.1136/lupus-2024-001163","DOIUrl":"10.1136/lupus-2024-001163","url":null,"abstract":"<p><strong>Objective: </strong>Neuropsychiatric SLE (NPSLE) has a broad spectrum and to date, there is no gold-standard biomarker. The diagnosis relies on clinical assessment, supporting examinations and exclusion of other possible aetiologies. One method that can be used to establish NPSLE is to conduct a re-evaluation by involving several fields of medical science. This study aims to reassess SLE cases with neuropsychiatric (NP) manifestations through multidisciplinary re-evaluation and determine the final diagnosis of NPSLE or non-NPSLE.</p><p><strong>Methods: </strong>This retrospective cross-sectional study used medical record data from patients with SLE with NP manifestations. Inclusion criteria included patients diagnosed with SLE, who had clinical manifestations of NP and were >18 years old. Multidisciplinary re-evaluation was conducted and agreed upon the diagnosis of NPSLE or non-NPSLE.</p><p><strong>Results: </strong>We included 94 subjects with a total of 132 NP events consisting of 69 NPSLE and 63 non-NPSLE. After re-evaluating NPSLE events, 33.3% were still concluded to be NPSLE. Meanwhile, from the non-NPSLE group, 22.2% were then declared as NPSLE. There were no significant differences in demographic characteristics between the NPSLE and non-NPSLE groups. The proportion of NP events in both groups was almost the same except for cerebrovascular disease manifestations which were more common in the NPSLE group. Higher Mexican SLE Disease Activity Index scores with (p<0.001) or without NP (p=0.02) were observed in the NPSLE group compared with the non-NPSLE group, as well as higher proportion of active disease (p=0.03), higher anti-double-stranded DNA titres (p<0.001) and lower values of C3 (p=0.018) and C4 (p=0.001).</p><p><strong>Conclusions: </strong>Multidisciplinary re-evaluation can be used as a method to confirm the diagnosis of NPSLE. There is a tendency for overdiagnosis of NPSLE when clinicians are faced with NP events in patients with SLE. Complete clinical and supporting data are needed to determine the final diagnosis of NPSLE.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"11 1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11163663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141293552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}