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Comparison of flares in 85 patients with SLE who maintained, discontinued or reduced dose of hydroxychloroquine during a prospective study of ophthalmological screening for retinopathy (PERFOCTAPS Study). 在一项眼科视网膜病变筛查的前瞻性研究(PERFOCTAPS研究)中,85例维持、停止或减少羟氯喹剂量的SLE患者的耀斑比较。
IF 3.7 2区 医学
Lupus Science & Medicine Pub Date : 2025-03-12 DOI: 10.1136/lupus-2024-001434
Joana Isabel Marques Dias, Kevin Chevalier, Vivien Vasseur, Elsa Laumonier, Sabine Derrien, Nathalie Morel, Véronique Le Guern, Alexis Mathian, Luc Mouthon, Martine Mauget Faÿsse, Yann Nguyen, Nathalie Costedoat-Chalumeau
{"title":"Comparison of flares in 85 patients with SLE who maintained, discontinued or reduced dose of hydroxychloroquine during a prospective study of ophthalmological screening for retinopathy (PERFOCTAPS Study).","authors":"Joana Isabel Marques Dias, Kevin Chevalier, Vivien Vasseur, Elsa Laumonier, Sabine Derrien, Nathalie Morel, Véronique Le Guern, Alexis Mathian, Luc Mouthon, Martine Mauget Faÿsse, Yann Nguyen, Nathalie Costedoat-Chalumeau","doi":"10.1136/lupus-2024-001434","DOIUrl":"10.1136/lupus-2024-001434","url":null,"abstract":"<p><strong>Objective: </strong>Little is known about the risk of SLE flares associated with hydroxychloroquine (HCQ) reduction or cessation, especially after ophthalmological screening. We analysed the risk of SLE flares after HCQ reduction or discontinuation after detection of early ophthalmological toxicity.</p><p><strong>Methods: </strong>This study includes all patients with SLE among the 109 included in the prospective PERFOCTAPS Study and treated with HCQ for at least 5 years. Patients were divided into 3 groups: HCQ maintenance, reduction and discontinuation after intensive ophthalmological screening. Flare occurrence (SELENA-SLEDAI Flare Index) was assessed for 2 years after HCQ reduction or discontinuation or after inclusion in the maintenance group.</p><p><strong>Results: </strong>This study included 85 patients (98% women, mean age 40.0 years, and mean durations of SLE and HCQ treatment 14.4±7.7 years and 12.9±7.2 years, respectively). The PERFOCTAPS Study identified ophthalmological abnormalities in 25 patients (29.4%); these led to dose reduction in 20 patients and discontinuation in 5. Flares occurred in 29 patients (34.1%): 17 (28.3%) in the maintenance group, 10 (50%) in the reduction group and 2 (40%) in the discontinuation group. After adjustment for potential confounders, HCQ reduction was independently associated with the risk of flare (adjusted HR 2.26; 95% CI 1.03 to 4.97). The same trend was observed in the discontinuation group, but was no longer statistically significant (adjusted HR 2.13; 95% CI 0.44 to 10.27).</p><p><strong>Conclusion: </strong>In this prospective study, HCQ reduction due to early suspicion of retinal toxicity was associated with a statistically significantly increased risk of disease flare.</p><p><strong>Trial registration number: </strong>NCT02719002.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625201","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}
引用次数: 0
Evaluation of the effects of pre-exposure treatment with hydroxychloroquine on the risk of COVID-19 infection and on the efficacy of anti-COVID-19 vaccination during lupus or Gougerot-Sjögren's disease: Prepcov multicentre trial. 评估暴露前羟氯喹治疗对狼疮或 Gougerot-Sjögren 病期间 COVID-19 感染风险和抗 COVID-19 疫苗接种疗效的影响:Prepcov 多中心试验。
IF 3.7 2区 医学
Lupus Science & Medicine Pub Date : 2025-03-05 DOI: 10.1136/lupus-2024-001435
Laurent Alric, Clara Brusq, Marion Migueres, Stephanie Faure, Pascal Lebray, Jean François Viallard, Dominique Chauveau, Laurent Sailler, Emilie Bérard, Grégory Pugnet, Patrice Cacoub
{"title":"Evaluation of the effects of pre-exposure treatment with hydroxychloroquine on the risk of COVID-19 infection and on the efficacy of anti-COVID-19 vaccination during lupus or Gougerot-Sjögren's disease: Prepcov multicentre trial.","authors":"Laurent Alric, Clara Brusq, Marion Migueres, Stephanie Faure, Pascal Lebray, Jean François Viallard, Dominique Chauveau, Laurent Sailler, Emilie Bérard, Grégory Pugnet, Patrice Cacoub","doi":"10.1136/lupus-2024-001435","DOIUrl":"10.1136/lupus-2024-001435","url":null,"abstract":"<p><strong>Objectives: </strong>Some patients with SLE or Gougerot-Sjögren's disease (GSD) receive long-term treatment with hydroxychloroquine (HCQ), sometimes combined with immunosuppressive therapy (IS). This study sought to assess whether long-term HCQ therapy that had been initiated long before the COVID-19 pandemic had a protective or adverse effect on COVID-19 risk, severity of infection or immunity protection.</p><p><strong>Methods: </strong>This prospective multicentre study included 547 patients with SLE, GSD, autoimmune hepatitis, primary biliary cholangitis or cured viral hepatitis C divided into four groups according to HCQ (+/-) and IS (+/-) intake prior to the pandemic: HCQ+IS+ (n=112), HCQ+IS- (n=121), HCQ-IS+ (n=115) and HCQ-IS- (n=199). When COVID-19 vaccination was possible, patients were vaccinated as recommended. Vaccination efficacy was prospectively assessed on the basis of the postvaccination antibody titre.</p><p><strong>Results: </strong>Compared with HCQ+IS+ patients, HCQ-IS+ patients had a decreased risk of COVID-19 infection (p<0.001). Compared with HCQ+IS+ patients, HCQ-IS- patients had a decreased risk of contracting COVID-19 (p<0.001). Patients in the HCQ-IS+ or HCQ-IS- group had a lower risk of symptomatic or severe infection than HCQ+IS+ patients did (p=0.001 and p<0.001, respectively). Only patients who had two or more exposures (to vaccine and/or infection) had an increased likelihood of COVID-19 immunity after the last dose (p<0.001).</p><p><strong>Conclusions: </strong>HCQ treatment that was initiated before the pandemic did not protect against COVID-19 infection. Moreover, non-exposure to HCQ treatment (combined or not with IS) was associated with decreased risk of COVID-19 infection and of developing a symptomatic or severe infection. HCQ and IS do not influence the vaccine response. Only two or more doses of vaccine result in a good vaccine response.</p><p><strong>Trial registration number: </strong>NCT04481633.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567203","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}
引用次数: 0
Systematic review of the reporting of extrarenal manifestations in observational studies of Saudi patients with systemic lupus erythematosus. 对沙特系统性红斑狼疮患者观察性研究中肾外表现报告的系统性回顾。
IF 3.7 2区 医学
Lupus Science & Medicine Pub Date : 2025-03-05 DOI: 10.1136/lupus-2024-001469
Fahidah Alenzi, Roaa Aljohani, Aos Aboabat, Fehaid Alanazi, Haya M Almalag, Mohammed A Omair
{"title":"Systematic review of the reporting of extrarenal manifestations in observational studies of Saudi patients with systemic lupus erythematosus.","authors":"Fahidah Alenzi, Roaa Aljohani, Aos Aboabat, Fehaid Alanazi, Haya M Almalag, Mohammed A Omair","doi":"10.1136/lupus-2024-001469","DOIUrl":"10.1136/lupus-2024-001469","url":null,"abstract":"<p><strong>Background: </strong>SLE is prevalent in Saudi Arabia, with numerous studies focusing on SLE in adult patients. However, there is a lack of comprehensive studies summarising the extrarenal manifestations of SLE in this population. This study aims to assess the variability in the prevalence rates of extrarenal manifestations of SLE across different cities in Saudi Arabia and to emphasise the need for a national registry to better understand the overall disease burden in the region.</p><p><strong>Methods: </strong>We conducted a systematic review of articles with no time restrictions, including studies from databases such as Medline, ScienceDirect, EBSCO and PubMed up to July 2024. The review process involved screening, data extraction and quality assessment in duplicate. Only observational or experimental studies focusing on extrarenal manifestations in adult patients with SLE in Saudi Arabia were included. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist for systematic reviews to ensure a rigorous and comprehensive evaluation.</p><p><strong>Results: </strong>A total of 35 studies were included, primarily retrospective cohort studies. Riyadh showed the highest number of publications over time. Musculoskeletal involvement in SLE ranged from 2% to 100%, with most studies reporting 46%-85%. Mucocutaneous manifestations, including discoid rash (5%-100%), malar rash (up to 79%) and photosensitivity (6.12%-29.3%), varied widely. Raynaud's phenomenon was noted at 4.5%-15.2%. Constitutional symptoms were more common in early-onset SLE, while serositis and cardiopulmonary issues showed variability. Neuropsychiatric symptoms, especially depression, reached up to 67.6%.</p><p><strong>Conclusion: </strong>This study explores the prevalence of extrarenal manifestations of SLE among adult Saudi patients, highlighting significant regional variability in musculoskeletal, dermatological, cardiovascular and neurological symptoms. It addresses a gap in the literature for a region where autoimmune diseases are a growing public health concern. The findings emphasise the need for population-based studies to investigate environmental, genetic and lifestyle factors influencing SLE progression.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567207","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}
引用次数: 0
Meeting report: The Systemic Lupus International Collaborating Clinics (SLICC) World Lupus Seminar on Africa. 会议报告:系统性狼疮国际合作诊所(SLICC)非洲世界狼疮研讨会。
IF 3.5 2区 医学
Lupus Science & Medicine Pub Date : 2025-03-03 DOI: 10.1136/lupus-2024-001452
Alexandra Legge, John A Reynolds, Manuel Francisco Ugarte-Gil, Olufemi Adelowo, Ashira Blazer, Dzifa Dey, Eunice Omondi, Omondi Oyoo, Rosalind Ramsey-Goldman
{"title":"Meeting report: The Systemic Lupus International Collaborating Clinics (SLICC) World Lupus Seminar on Africa.","authors":"Alexandra Legge, John A Reynolds, Manuel Francisco Ugarte-Gil, Olufemi Adelowo, Ashira Blazer, Dzifa Dey, Eunice Omondi, Omondi Oyoo, Rosalind Ramsey-Goldman","doi":"10.1136/lupus-2024-001452","DOIUrl":"10.1136/lupus-2024-001452","url":null,"abstract":"<p><p>The Systemic Lupus International Collaborating Clinics (SLICC) is an international research group dedicated to promoting collaboration among scientific investigators in the study of systemic lupus erythematosus (SLE). Currently, most SLICC members are based in North America and Europe, with limited representation from other regions. SLICC recognises the importance of expanding its global collaborations and representation to ensure that its research accurately reflects the global burden of SLE and provides equal benefit to all patients with SLE worldwide. Given that SLICC currently lacks representation from the African continent, an opportunity was identified to convene a meeting bringing together lupus physicians with experience providing clinical care and conducting lupus research in Africa, along with members of the SLICC group. The purpose of the meeting was to share information regarding SLE in Africa, to discuss recent innovations and current challenges in the region and to explore future collaborations between SLICC members and colleagues in Africa in the areas of SLE clinical care, research and education. This meeting report highlights information presented during the seminar as well as a discussion of next steps moving forward.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542477","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}
引用次数: 0
Mortality patterns of SLE and the associated risk factors in Korean patients: a nationwide cohort study. 韩国患者SLE死亡模式及相关危险因素:一项全国性队列研究
IF 3.7 2区 医学
Lupus Science & Medicine Pub Date : 2025-02-26 DOI: 10.1136/lupus-2024-001361
Soo-Kyung Cho, Yena Jeon, Jung-Hyo Kim, Eun Jin Jang, Sun-Young Jung, Yoon-Kyoung Sung
{"title":"Mortality patterns of SLE and the associated risk factors in Korean patients: a nationwide cohort study.","authors":"Soo-Kyung Cho, Yena Jeon, Jung-Hyo Kim, Eun Jin Jang, Sun-Young Jung, Yoon-Kyoung Sung","doi":"10.1136/lupus-2024-001361","DOIUrl":"10.1136/lupus-2024-001361","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the mortality patterns of SLE and the associated risk factors in Koreans.</p><p><strong>Methods: </strong>Using the National Health Insurance database spanning 2008 to 2018, incident cases of SLE in patients aged 10-79 years were included. We analysed the all-cause mortality and cause-specific mortality, stratifying by sex and age. The mortality rate (MR) was calculated as the number of deaths per 100 000 person-years (PYs). The causes of death were identified by the International Classification of Diseases, 10th Revision codes during hospitalisation or emergency visit prior to death. A generalised estimating equation model was employed for risk factor analysis.</p><p><strong>Results: </strong>In total, 11 375 incident SLE cases among patients with an average age of 42.3±16.7 years were recruited (86.1% female). During 57 658 PYs, 728 deaths occurred (MR 1262.62/100 000 PYs). The MR among men (2718.86/100 000 PYs) exceeded that among women (1060.57/100 000 PYs). The leading causes of death were SLE-related conditions (381.56/100 000 PYs), cardiovascular disease (CVD) (202.92/100 000 PYs), cancer (175.17/100 000 PYs) and infection (143.95/100 000 PYs). Of the SLE-related mortality, the key risk factors were pulmonary complications, such as pulmonary alveolar haemorrhage (OR 9.93), pulmonary arterial hypertension (OR 3.77) and interstitial lung disease (OR 3.27).</p><p><strong>Conclusions: </strong>Among Korean patients with SLE, SLE-related conditions were the leading causes of mortality. However, CVD and cancer were also identified as the main causes of mortality. Furthermore, pulmonary manifestations were significantly associated with SLE-related mortality.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515962","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}
引用次数: 0
Development and evaluation of a Register-Based Organ Damage Index in systemic lupus erythematosus: a nationwide, population-based study from Sweden. 系统性红斑狼疮基于登记的器官损伤指数的发展和评估:一项来自瑞典的全国性、基于人群的研究。
IF 3.7 2区 医学
Lupus Science & Medicine Pub Date : 2025-02-26 DOI: 10.1136/lupus-2024-001403
Alvaro Gomez, Ioannis Parodis, Muna Saleh, Julia F Simard, Christopher Sjöwall, Elizabeth V Arkema
{"title":"Development and evaluation of a Register-Based Organ Damage Index in systemic lupus erythematosus: a nationwide, population-based study from Sweden.","authors":"Alvaro Gomez, Ioannis Parodis, Muna Saleh, Julia F Simard, Christopher Sjöwall, Elizabeth V Arkema","doi":"10.1136/lupus-2024-001403","DOIUrl":"10.1136/lupus-2024-001403","url":null,"abstract":"<p><strong>Objective: </strong>To develop a Register-Based Organ Damage Index (RBODI) in SLE, and evaluate its accuracy in estimating Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index (SDI) scores. Additionally, to describe organ damage accrual and associations with mortality in a Swedish population-based nationwide cohort.</p><p><strong>Methods: </strong>SDI items were translated into diagnosis, treatment and procedural codes retrieved from Swedish health registers. RBODI was calculated using the same rules as the SDI and its accuracy was evaluated using SDI data from the <i>Clinical Lupus Register in North-Eastern Gothia</i> cohort as the gold standard. Among newly diagnosed patients with SLE from Sweden (2005-2021), we estimated 5-year risks of organ damage, and adjusted HRs of first RBODI-based organ damage accrual associated with patient characteristics. Lastly, we estimated the association between RBODI-based organ damage within 5 years of diagnosis and mortality.</p><p><strong>Results: </strong>The evaluation cohort included 271 prevalent cases (65.3% developed organ damage). RBODI had a positive predictive value of 90%, sensitivity 80% and specificity 83%. Among 4441 newly diagnosed patients with SLE, 40% developed organ damage within 5 years. Males had a 30% higher risk of developing damage compared with females (HR 1.3) and older individuals (>45 years old compared with younger) had more than threefold higher risk (HR 3.3). Early development of organ damage was associated with a 2.1-fold higher risk of mortality.</p><p><strong>Conclusion: </strong>Our novel RBODI accurately estimates SDI scores and describes long-term trends in damage accrual in the largest cohort of incident SLE to date. The strong association between early damage accrual and mortality highlights the need for efficient prevention strategies.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515958","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}
引用次数: 0
Hydroxychloroquine in patients with systemic lupus erythematosus: how much is enough? 羟氯喹用于系统性红斑狼疮患者:多少才够?
IF 3.7 2区 医学
Lupus Science & Medicine Pub Date : 2025-02-26 DOI: 10.1136/lupus-2024-001254
Guillermo Ruiz-Irastorza, Diana Paredes-Ruiz, Fernando Arizpe, Valerio Campos-Rodriguez, Victor Moreno-Torres, Laura Amo, Ioana Ruiz-Arruza, Daniel Martin-Iglesias
{"title":"Hydroxychloroquine in patients with systemic lupus erythematosus: how much is enough?","authors":"Guillermo Ruiz-Irastorza, Diana Paredes-Ruiz, Fernando Arizpe, Valerio Campos-Rodriguez, Victor Moreno-Torres, Laura Amo, Ioana Ruiz-Arruza, Daniel Martin-Iglesias","doi":"10.1136/lupus-2024-001254","DOIUrl":"10.1136/lupus-2024-001254","url":null,"abstract":"<p><strong>Objective: </strong>To assess the daily and weight-adjusted dosages of hydroxychloroquine (HCQ) and the effects on long-term remission in the Lupus-Cruces cohort.</p><p><strong>Methods: </strong>Observational study of routine clinical care data. We selected inception patients treated with HCQ with at least 5 years of follow-up. Prolonged remission was achieved when patients fulfilled definitions of remission in systemic lupus erythematosus remission criteria in five consecutive yearly visits. The associations between the weight-adjusted dose of HCQ during 5 years and prolonged remission were analysed. We also investigated the associations between prednisone doses, immunosuppressives (IS) and other antimalarial use with HCQ doses.</p><p><strong>Results: </strong>150 inception patients fulfilled the inclusion criteria. The mean starting dose of HCQ was 206 mg/day. The mean weight-adjusted starting dose of HCQ was 3.1 mg/kg/day with no patients treated with doses ≥5 mg/kg/day. Treatment with HCQ was maintained during the whole 5-year follow-up time in 147 patients (98%). The mean dose of HCQ during the 5-year follow-up was 194.6 mg/day (2.9 mg/kg/day). 108 patients (72%) were in prolonged remission. The mean weight-adjusted dose of HCQ per patient did not differ between those who did and did not achieve prolonged remission (2.9 vs 3 mg/kg/day, p=0.5). The dose of prednisone per patient (mean 2.3 mg/day during the 5-year follow-up) did not differ according to the weight-adjusted dose of HCQ. The mean weight-adjusted HCQ dose during the whole follow-up was the same in patients treated or not with IS or with mepacrine.</p><p><strong>Conclusions: </strong>With the use of HCQ at stable doses of 200 mg/day (or 3.0-3.5 mg/kg/day) as the background therapy in patients with systemic lupus erythematosus, the majority of patients achieved prolonged remission.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515959","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}
引用次数: 0
Real-world oral glucocorticoid use in SLE: a nation-wide population-based study using the French medico-administrative (SNDS) claim database. 真实世界口服糖皮质激素在SLE中的使用:一项使用法国医疗管理(SNDS)索赔数据库的全国性人群研究。
IF 3.7 2区 医学
Lupus Science & Medicine Pub Date : 2025-02-18 DOI: 10.1136/lupus-2024-001428
Laurent Arnaud, Caroline Fabry-Vendrand, Remus Todea, Blandine Vidal, Juliette Cottin, Isabelle Bureau, Stéphane Bouée, Gabriel Thabut
{"title":"Real-world oral glucocorticoid use in SLE: a nation-wide population-based study using the French medico-administrative (SNDS) claim database.","authors":"Laurent Arnaud, Caroline Fabry-Vendrand, Remus Todea, Blandine Vidal, Juliette Cottin, Isabelle Bureau, Stéphane Bouée, Gabriel Thabut","doi":"10.1136/lupus-2024-001428","DOIUrl":"10.1136/lupus-2024-001428","url":null,"abstract":"<p><strong>Background: </strong>Oral glucocorticoids (OCS) remain one of the most important treatments for SLE but are associated with damage. Evidence regarding the real-world use of OCS in nationwide SLE populations is currently lacking. The aim of this study was to analyse OCS use and SLE treatments in French patients with SLE at the national level.</p><p><strong>Methods: </strong>The nationwide French health insurance claims database, which contains pseudonymised data for ≈66 million people, was used. Prevalent patients with SLE (International Classification of Diseases, 10th Revision code M32, recorded as a chronic condition or associated with hospital stay) were identified over the year 2019. SLE treatments were captured through actual drug deliveries by pharmacies and mean daily OCS doses (prednisone equivalent) were calculated for the year 2019.</p><p><strong>Results: </strong>The 2019 French prevalent SLE population comprised 31 852 patients (86.3% of women, with a mean age of 49.7 (±15.9) years) with a mean disease duration of 7.1 (±6.2) years. Among these, 48.3% were treated with OCS. The mean daily OCS dose was ≤5 mg/day in 35.9%, more than 5 mg but <7.5 mg/day in 6.4% and ≥7.5 mg/day in 6.0%. The use of other SLE treatments was significantly increased in patients with higher doses of OCS (p<0.0001). Potential complications of OCS, including cardiovascular diseases, infections and osteoporosis, were significantly increased in patients with SLE receiving more than 5 mg of OCS per day (p<0.0001, for all). Strikingly, 13.6% of patients receiving mean daily OCS doses >5 mg/day were not treated with antimalarial, immunosuppressant or biologic drugs for SLE.</p><p><strong>Conclusions: </strong>In total, 48.2% of French patients with SLE were treated with OCS in 2019, including 12.4% at a mean dose >5 mg/day, with an increased risk of OCS complications and a limited use of antimalarials, immunosuppressants or biologics. These results highlight the urgent need for the implementation of more robust OCS-sparing strategies in SLE.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448282","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}
引用次数: 0
Autoimmune encephalitis associated with anti-LGI1 antibody: a potential cause of neuropsychiatric systemic lupus erythematosus. 与抗lgi1抗体相关的自身免疫性脑炎:神经精神系统性红斑狼疮的潜在原因
IF 3.7 2区 医学
Lupus Science & Medicine Pub Date : 2025-02-18 DOI: 10.1136/lupus-2024-001429
Sixian Chen, Haitao Ren, Siyuan Fan, Shangzhu Zhang, Mengtao Li, Hongzhi Guan
{"title":"Autoimmune encephalitis associated with anti-LGI1 antibody: a potential cause of neuropsychiatric systemic lupus erythematosus.","authors":"Sixian Chen, Haitao Ren, Siyuan Fan, Shangzhu Zhang, Mengtao Li, Hongzhi Guan","doi":"10.1136/lupus-2024-001429","DOIUrl":"10.1136/lupus-2024-001429","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the clinical features and treatment outcomes of anti-leucine-rich glioma-inactivated 1 (anti-LGI1) encephalitis in patients with SLE.</p><p><strong>Methods: </strong>Between October 2014 and April 2024, serum or cerebrospinal fluid samples were collected from 332 patients with SLE suspected of autoimmune encephalitis. Cell-based assays were used to detect autoimmune antibodies, including anti-LGI1 antibodies. Four patients tested positive for anti-LGI1 antibodies, and their clinical, radiological and treatment data were analysed.</p><p><strong>Results: </strong>All four patients exhibited signs of limbic encephalitis, including short-term memory deficits, seizures and psychiatric disturbances. Two cases also presented with faciobrachial dystonic seizures. MRI findings revealed hyperintense basal ganglia lesions in two patients. Treatment with corticosteroids, intravenous immunoglobulin and mycophenolate mofetil led to significant improvement in three patients, with no relapses during a follow-up period ranging from 33 to 60 months. One patient succumbed to pneumonia despite initial improvement of neurological function.</p><p><strong>Conclusion: </strong>Screening for anti-LGI1 antibodies in patients with neuropsychiatric systemic lupus erythematosus (NPSLE) is crucial when limbic encephalitis presents, as it enables timely and effective treatment, potentially improving patients' outcomes. Additional basic and clinical research is required to clarify the pathogenic role of these antibodies in NPSLE.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449370","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}
引用次数: 0
Evaluation of primary aldosteronism testing in hypertensive patients with SLE in a tertiary hospital. 某三级医院合并SLE高血压患者原发性醛固酮增多症检测的评价
IF 3.7 2区 医学
Lupus Science & Medicine Pub Date : 2025-02-18 DOI: 10.1136/lupus-2025-001524
Matthew Wong, Alberta Y Hoi, Joanna R Kent, Peter J Fuller, Jun Yang, Fabien B Vincent
{"title":"Evaluation of primary aldosteronism testing in hypertensive patients with SLE in a tertiary hospital.","authors":"Matthew Wong, Alberta Y Hoi, Joanna R Kent, Peter J Fuller, Jun Yang, Fabien B Vincent","doi":"10.1136/lupus-2025-001524","DOIUrl":"10.1136/lupus-2025-001524","url":null,"abstract":"","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448314","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}
引用次数: 0
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