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Lupus Science & Medicine

Mimi Kim, Joan T Merrill, Kenneth Kalunian, Leslie Hanrahan, Peter Izmirly
Objective: To evaluate response duration and identify predictors of transitioning into and out of the response state in patients with SLE receiving standard of care (SoC) in 52-week clinical trials. Methods: A multistate model (MSM) allowing for bidirectional transitions between response and non-response states was fit to data on 759 patients with SLE with active disease randomised to SoC. The probability of being in response at 52 weeks, average duration of response (sojourn time) and mean total time in response for SLE Responder Index (SRI-4, SRI-5, SRI-6) and BILAG-based Composite Lupus Assessment (BICLA) were estimated...
2018: Lupus Science & Medicine
Rachael P Jackman, Giovanna I Cruz, Joanne Nititham, Darrell J Triulzi, Lisa F Barcellos, Lindsey A Criswell, Philip J Norris, Michael P Busch
Objectives: Rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) disproportionately affect women during and following childbearing years. Antihuman leucocyte antigen (HLA) alloantibody responses are common in healthy parous women, and as these diseases are both linked with HLA and immune dysregulation, we sought to evaluate anti-HLA antibodies in RA and SLE. Methods: Anti-HLA antibodies were measured among parous SLE cases (n=224), parous RA cases (n=202) and healthy parous controls (n=239) and compared with each other as well as with nulliparous female and male controls...
2018: Lupus Science & Medicine
Vinicius Domingues, Benjamin A Levinson, Nicole Bornkamp, Judith D Goldberg, Jill Buyon, H Michael Belmont
Objectives: The study aimed to determine if serum albumin at 12 months predicts long-term renal outcome at 48 months. Data from the NYU SAMPLE (Specimen and Matched Phenotype Linked Evaluation) Lupus Registry were used to compare the performance of albumin, anti-double-stranded DNA, C3/C4, proteinuria and haematuria. Methods: 82 patients with SLE with data at time of renal biopsy, at 12 months and at a second visit, and up to 48 months were included. The significance of each biomarker as a predictor of an adverse renal outcome (ARO), defined as doubling of serum creatinine, as creatinine >4 mg/dL if initial >2...
2018: Lupus Science & Medicine
(no author information available yet)
[This corrects the article DOI: 10.1136/lupus-2018-000276.].
2018: Lupus Science & Medicine
Rebecca E Sadun, Laura E Schanberg
The prevalence of paediatric-onset SLE (pSLE) is estimated at 1million people worldwide and accounts for a significant proportion of SLE morbidity, mortality and cost. Patients with pSLE are especially vulnerable during and immediately following transfer from paediatric to adult rheumatology care, when substantial delays in care and increased disease activity are common. Transition is the process through which adolescents and young adults (AYA) develop the skills needed to succeed in the adult healthcare environment, a process that typically takes several years and may span a patient's time in paediatric and adult clinics...
2018: Lupus Science & Medicine
Zara Izadi, Julie Gandrup, Patricia P Katz, Jinoos Yazdany
Inclusion of patient-reported outcomes is important in SLE clinical trials as they allow capture of the benefits of a proposed intervention in areas deemed pertinent by patients. We aimed to compare the measurement properties of health-related quality of life (HRQoL) measures used in adults with SLE and to evaluate their responsiveness to interventions in randomised controlled trials (RCTs). A systematic review was undertaken using full original papers in English identified from three databases: MEDLINE, EMBASE and PubMed...
2018: Lupus Science & Medicine
Nicola Edwards, Alexander W W Langford-Smith, Benjamin J Parker, Ian N Bruce, John A Reynolds, M Yvonne Alexander, Eoghan M McCarthy, Fiona L Wilkinson
Objective: 10-year cardiovascular disease (CVD) risk scores are calculated using algorithms, including Framingham (worldwide) and QRISK2 (UK). Recently, an updated QRISK3 model was introduced, which considers new variables including SLE and steroid prescription, not included in QRISK2 and Framingham algorithms. We sought to determine the extent to which QRISK3 improves identification of high-risk patients with SLE and whether the score relates to standard and novel markers of SLE-specific endothelial dysfunction...
2018: Lupus Science & Medicine
(no author information available yet)
[This corrects the article DOI: 10.1136/lupus-2017-000215.317.][This corrects the article DOI: 10.1136/lupus-2017-000215.317.].
2018: Lupus Science & Medicine
Cristina M Lanata, Sharon A Chung, Lindsey A Criswell
SLE is a complex autoimmune disease that results from the interplay of genetics, epigenetics and environmental exposures. DNA methylation is an epigenetic mechanism that regulates gene expression and tissue differentiation. Among all the epigenetic modifications, DNA methylation perturbations have been the most widely studied in SLE. It mediates processes relevant to SLE, including lymphocyte development, X-chromosome inactivation and the suppression of endogenous retroviruses. The establishment of most DNA methylation marks occurs in utero; however, a small percentage of epigenetic marks are dynamic and can change throughout a person's lifetime and in relation to exposures...
2018: Lupus Science & Medicine
Alexandra Perel-Winkler, Sabahat Bokhari, Thania Perez-Recio, Afshin Zartoshti, Anca Askanase, Laura Geraldino-Pardilla
Objectives: Cardiovascular diseaseand heart failure (CHF) are leading causes of death in systemic lupus erythematosus (SLE). The underlying mechanisms for increased CHF in SLE are unclear but myocardial inflammation and lupus myocarditis (LM) may play a role. We propose that 18 F-fluorodeoxyglucose-positron emission tomography (18 F-FDG-PET)/CT can help diagnose LM. Methods: This report describes eight patients with presumed LM; five patients were evaluated due to active cardiorespiratory symptoms and three patients were participating in a pilot study to determine the prevalence of subclinical myocarditis in SLE...
2018: Lupus Science & Medicine
Eric S Zollars, Madison Hyer, Bethany Wolf, Russell Chapin
Objective: Arthritis in SLE is poorly described, and there is no objective measure for quantification of arthritis. In this pilot study, we aim to assess the utility of the Rheumatoid Arthritis MRI Scoring System (RAMRIS) for the quantification of lupus arthritis. Methods: Patients were eligible for entry into the study if they were evaluated at the Medical University of South Carolina Lupus Center and determined by their treating rheumatologist to have active hand arthritis due to SLE...
2018: Lupus Science & Medicine
(no author information available yet)
[This corrects the article DOI: 10.1136/lupus-2018-000258.].
2018: Lupus Science & Medicine
Helena Idborg, Susanna Eketjäll, Susanne Pettersson, Johanna T Gustafsson, Agneta Zickert, Marika Kvarnström, Vilija Oke, Per-Johan Jakobsson, Iva Gunnarsson, Elisabet Svenungsson
Objectives: Composite criteria/indices are presently used to diagnose and monitor patients with systemic lupus erythematosus (SLE). Biomarkers for these purposes would be helpful in clinical practice. We therefore evaluated a large panel of cytokines and basic laboratory tests and investigated their performance as discriminators versus controls and as biomarkers of disease activity (DA). Methods: We examined 437 patients with SLE, fulfilling American College of Rheumatology-82 criteria, and 322 matched controls...
2018: Lupus Science & Medicine
Varsha Gupta, Vin Tangpricha, Eric Yow, Grace A McComsey, Laura Schanberg, Angela Byun Robinson
Objectives: Previous studies demonstrated associations between reduced serum 25-hydroxyvitamin D (25OHD), inflammation and disease activity in paediatric systemic lupus erythematosus (pSLE). The goal of this study was to assess parathyroid hormone (PTH) in its relationship to vitamin D and inflammation, as well as to better understand the role of human cathelicidin (LL-37) in pSLE. Methods: Frozen serum samples collected at baseline of the Atherosclerosis Prevention in Paediatric Lupus Erythematosus (APPLE) study were assayed to determine 25OHD, PTH and LL-37 levels...
2018: Lupus Science & Medicine
Christine Anastasiou, Olivia Dulai, Amrutha Baskaran, James Proudfoot, Samuel Verhaegen, Kenneth Kalunian
Objectives: To describe how immunosuppressant use and hospitalisation patterns for SLE have evolved by comparing admission statistics at one academic centre between 2005 and 2013. Methods: We identified admissions for SLE and for all hospitalised patients by using the hospital electronic database. For adult patients with SLE, a comprehensive chart review was conducted to identify primary indications for hospitalisation, in-hospital mortality, mean length of stay and immunosuppressant use...
2018: Lupus Science & Medicine
Joan T Merrill, Michelle A Petri, Jill Buyon, Rosalind Ramsey-Goldman, Kenneth Kalunian, Chaim Putterman, John Conklin, Richard A Furie, Thierry Dervieux
Background: We examined the usefulness of erythrocyte-bound C4d (EC4d) to monitor disease activity in SLE. Methods: Data and blood samples were collected from three different studies, each of which included longitudinal evaluations using the Physicians Global Assessment (PGA) of disease activity and the Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA) SLE Disease Activity Index (SLEDAI), which was assessed without anti-double-stranded DNA (dsDNA) and low complement C3/C4 (clinical SELENA-SLEDAI)...
2018: Lupus Science & Medicine
Karolina Åkesson, Susanne Pettersson, Sara Ståhl, Izabella Surowiec, Mattias Hedenström, Susanna Eketjäll, Johan Trygg, Per-Johan Jakobsson, Iva Gunnarsson, Elisabet Svenungsson, Helena Idborg
Objective: Fatigue has been reported as the most disturbing symptom in a majority of patients with SLE. Depression is common and often severe. Together these symptoms cause significant morbidity and affect patients with otherwise relatively mild disease. Tryptophan and its metabolites in the kynurenine pathway are known to be important in several psychiatric conditions, for example, depression, which are often also associated with fatigue. We therefore investigated the kynurenine pathway in patients with SLE and controls...
2018: Lupus Science & Medicine
Yudong Liu, Nickie L Seto, Carmelo Carmona-Rivera, Mariana J Kaplan
Objectives: Activation of endosomal toll-like receptor (TLR)7 or TLR9 has been proposed as a critical step for the initiation and development of SLE. Traditional spontaneous lupus models normally introduce multiple risk alleles, thereby adding additional confounding factors. In the induced lupus models, the role of TLR9 remains unclear. In the present study, we explored the role of an imbalance between TLR7 and TLR9 pathways in the pathogenesis of lupus and its associated vasculopathy using the imiquimod model in TLR9 KO/B6 background...
2018: Lupus Science & Medicine
Julie E Davidson, Qinggong Fu, Sapna Rao, Laurence S Magder, Michelle Petri
Objective: Corticosteroids are a mainstay of SLE treatment; however, cumulative steroid exposure may lead to organ damage. This study aimed to quantify the risk of new diabetes, hypertension, cataracts, osteoporosis and avascular necrosis that is attributable to cumulative corticosteroid exposure in SLE. Methods: Using data from the Hopkins Lupus Cohort, a longitudinal study of lupus activity, organ damage and quality of life in patients with SLE, five matched case-control analyses nested within a prospectively enrolled SLE cohort were performed...
2018: Lupus Science & Medicine
Joan T Merrill, Susan Manzi, Cynthia Aranow, Anca Askenase, Ian Bruce, Eliza Chakravarty, Ben Chong, Karen Costenbader, Maria Dall'Era, Ellen Ginzler, Leslie Hanrahan, Ken Kalunian, Joseph Merola, Sandra Raymond, Brad Rovin, Amit Saxena, Victoria P Werth
Formidable impediments stand in the way of treatment development for lupus. These include the unwieldy size of current trials, international competition for scarce patients, complex outcome measures and a poor understanding of these outcomes in the world at large. The heterogeneity of the disease itself coupled to superimposition of variegated background polypharmacy has created enough immunological noise to virtually ensure the failure of lupus treatment trials, leaving an understandable suspicion that at least some of the results in testing failed drugs over the years may not have been negative, but merely uninterpretable...
2018: Lupus Science & Medicine
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