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lupus low disease activity state

Konstantinos Tselios, Dafna D Gladman, Murray B Urowitz
BACKGROUND: In recent years, low disease activity emerged as a state that is associated with improved long-term outcomes in systemic lupus erythematosus (SLE). Our aim was to review the current concepts for low disease activity in SLE in order to serve as the basis of a future consensus for standardization. METHODS: The PubMed database was searched for relevant articles from inception up to July 2018. Medical Subject Headings (MeSH terms) included "lupus" AND "low disease activity" OR "minimal disease activity"...
October 16, 2018: Seminars in Arthritis and Rheumatism
Rangi Kandane-Rathnayake, Vera Golder, Worawit Louthrenoo, Shue-Fen Luo, Yeong-Jian Jan Wu, Zhanguo Li, Yuan An, Aisha Lateef, Sargunan Sockalingam, Sandra V Navarra, Leonid Zamora, Laniyati Hamijoyo, Yasuhiro Katsumata, Masayoshi Harigai, Madelynn Chan, Sean O'Neill, Fiona Goldblatt, Yanjie Hao, Zhuoli Zhang, Jamal Al-Saleh, Munther Khamashta, Tsutomu Takeuchi, Yoshiya Tanaka, Sang-Cheol Bae, Chak Sing Lau, Alberta Hoi, Mandana Nikpour, Eric F Morand
AIM: The aim of this manuscript is to describe the development of the Asia Pacific Lupus Collaboration (APLC) cohort. METHOD: The APLC cohort is an ongoing, prospective longitudinal cohort. Adult patients who meet either the American College of Rheumatology (ACR) Modified Classification Criteria for systemic lupus erythematosus (SLE), or the Systemic Lupus International Collaborating Clinics (SLICC) Classification Criteria, and provide informed consent are recruited into the cohort...
November 5, 2018: International Journal of Rheumatic Diseases
Molly K Hritzo Ahye, Amit Golding
Systemic lupus erythematosus (SLE) is a manifestation of hyperactivated lymphocytes and results, in part, from the loss of normal tolerance checkpoints. FOXO1 is a transcription factor involved at critical early and late B cell development checkpoints; however, its role in regulating peripheral B cell tolerance is not fully understood. We have applied our published approach for using imaging flow cytometry to study native FOXO1 localisation in human lymphocytes to peripheral blood samples from healthy individuals versus patients with SLE...
2018: Lupus Science & Medicine
Eric F Morand, Teodora Trasieva, Anna Berglind, Gabor Illei, Raj Tummala
No abstract text is available yet for this article.
October 29, 2018: Annals of the Rheumatic Diseases
Michelle Petri, Laurence S Magder
No abstract text is available yet for this article.
December 2018: Arthritis & Rheumatology
Evrydiki Kravvariti, George Konstantonis, Petros P Sfikakis, Maria G Tektonidou
Objectives: The progression of subclinical atherosclerosis in SLE and RA has not been comparatively assessed. We sought to investigate the impact of low disease activity and other disease-related factors on atherosclerosis progression in SLE vs RA. Methods: We performed a 3-year follow-up carotid and femoral artery ultrasound in 101 patients with SLE, 85 with RA and 85 controls after a baseline examination in 115 SLE and 1:1 age- and gender-matched RA patients and controls...
December 1, 2018: Rheumatology
Helena L Silva-Neta, Maria C A Brelaz-de-Castro, Mardonny B O Chagas, Henrique A Mariz, Rodrigo G de Arruda, Viviane F de Vasconcelos, Michelly C Pereira, Audrey Romano, Ivan R Pitta, Claudia D L Marques, Angela L B P Duarte, Moacyr J B M Rêgo, Maira G R Pitta
Heren, we analyzed Treg cells as potential biomarkers of disease activity in systemic lupus erythematosus (SLE) patients. Peripheral blood mononuclear cells from 30 SLE patients (15 active: SLEDAI > 6/15 SLE remission: SLEDAI< 6) and 15 healthy volunteers were purified. Treg immunophenotyping was performed using CD4, CD25, CD45, CD127, and FOXP3 markers. CD4+ FOXP3+ Treg activation state was investigated based on CD45RA and FOXP3 expression. To increase the accuracy of our findings, a multivariate linear regression was performed...
2018: BioMed Research International
Michelle Petri, Laurence S Magder
OBJECTIVE: One objective in the treatment of systemic lupus erythematosus (SLE) disease activity is to reduce long-term rates of organ damage. We undertook this study to analyze data from a large clinical SLE cohort to compare patients achieving different levels of disease activity with respect to rates of long-term damage. METHODS: We analyzed data from 1,356 SLE patients in the Hopkins Lupus Cohort, followed up quarterly, with 77,105 person-months observed from 1987 to 2016...
November 2018: Arthritis & Rheumatology
Chi Chiu Mok
The treat-to-target (T2T) principle has been advocated in a number of inflammatory and non-inflammatory medical illnesses. Tight control of disease activity has been shown to improve the outcome of rheumatoid arthritis and psoriatic arthritis as compared to the conventional approach. However, whether T2T can be applied to patients with lupus nephritis is still under hot discussion. Treatment of lupus nephritis should target at inducing and maintaining remission of the kidney inflammation so as to preserve renal function and improve survival in the long-term...
April 5, 2018: Current Rheumatology Reviews
Antonis Fanouriakis, Christina Adamichou, Sofia Koutsoviti, Stylianos Panopoulos, Chrysanthi Staveri, Anastasia Klagou, Christina Tsalapaki, Lamprini Pantazi, Styliani Konsta, Clio P Mavragani, Despoina Dimopoulou, Styliani Ntali, Georgios Katsikas, Kyriaki A Boki, Dimitrios Vassilopoulos, Pinelopi Konstantopoulou, Stamatis-Nick Liossis, Antonia Elezoglou, Maria Tektonidou, Prodromos Sidiropoulos, Abdulsamet Erden, Petros P Sfikakis, George Bertsias, Dimitrios T Boumpas
BACKGROUND: Low disease activity is a validated target of current systemic lupus erythematosus (SLE) therapy. The aim of this study was to assess the ability of belimumab to achieve low disease activity states in real-life settings. METHODS: Multicentre prospective observational study of consecutive SLE patients receiving belimumab for at least 3 months, due to active disease refractory to at least one conventional immunosuppressant. Disease activity, including the recently defined lupus low disease activity state (LLDAS) and remission (clinical SLEDAI-2K = 0), accrual of organ damage, flares and side effects were documented...
February 23, 2018: Seminars in Arthritis and Rheumatism
Chiara Tani, Roberta Vagelli, Chiara Stagnaro, Linda Carli, Marta Mosca
Objectives: To evaluate what proportion of patients fulfil the DORIS definition of remission, the definition of lupus low disease activity state (LLDAS) and LLDAS with a glucocorticoid (GC) dosage ≤5 (LLDAS5) in a longitudinal monocentric cohort of patients with SLE; to identify predictors of sustained remission and LLDAS attainment; to evaluate the effect of sustained remission and LLDAS on damage accrual over a period of 5 years and compare the two conditions in terms of clinical outcomes...
2018: Lupus Science & Medicine
Eric F Morand, Teodora Trasieva, Anna Berglind, Gabor G Illei, Raj Tummala
OBJECTIVES: In a post-hoc analysis, we aimed to validate the Lupus Low Disease Activity State (LLDAS) definition as an endpoint in an systemic lupus erythematosus (SLE) Phase IIb randomised controlled trial (RCT) (MUSE [NCT01438489]) and then utilize LLDAS to discriminate between anifrolumab and placebo. METHODS: Patients received intravenous placebo (n=102) or anifrolumab (300 mg, n=99; 1,000 mg, n=104) Q4W plus standard of care for 48 weeks. LLDAS attainment (SLE Disease Activity Index 2000 ≤4 without major organ activity, no new disease activity, Physician's Global Assessment ≤1, prednisolone ≤7...
May 2018: Annals of the Rheumatic Diseases
Eric F Morand, Marta Mosca
Despite improvements in survival, outcomes of contemporary treatment of systemic lupus erythematosus (SLE) are unacceptable. Unlike in many diseases, treat-to-target (T2T) approaches have not been adopted in SLE, owing to a lack of validated targets to treat towards. Therefore, it is a key goal to validate target state definitions such as low disease activity and remission, and test their implementation in clinical practice and clinical trials. In this article, we review recent advances in T2T approaches in SLE, and emerging evidence-based consensus on definitions of remission and low disease activity that are needed to underpin such approaches...
June 2017: Best Practice & Research. Clinical Rheumatology
Matteo Piga, Alberto Floris, Giulia Cappellazzo, Elisabetta Chessa, Mattia Congia, Alessandro Mathieu, Alberto Cauli
BACKGROUND: The aim was to assess the attainability and outcome of the lupus low disease activity state (LLDAS) in the early stages of systemic lupus erythematosus (SLE). METHODS: LLDAS prevalence was evaluated at 6 (T1) and 18 (T2) months after diagnosis and treatment initiation (T0) in a monocentric cohort of 107 (median disease duration 9.7 months) prospectively followed Caucasian patients with SLE. Reasons for failure to achieve LLDAS were also investigated...
November 10, 2017: Arthritis Research & Therapy
Margherita Zen, Luca Iaccarino, Mariele Gatto, Francesca Saccon, Maddalena Larosa, Anna Ghirardello, Leonardo Punzi, Andrea Doria
OBJECTIVE: To evaluate the prevalence, duration and effect on damage accrual of the 'Lupus Low Disease Activity State' (LLDAS) in a monocentric cohort of patients with systemic lupus erythematosus (SLE). METHODS: We studied 293 Caucasian patients with SLE during a 7-year follow-up period. Disease activity was assessed by SLE Disease Activity Index 2000 (SLEDAI-2K) and SELENA-SLEDAI physician global assessment (PGA), and damage by Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI)...
January 2018: Annals of the Rheumatic Diseases
Manuel Francisco Ugarte-Gil, Daniel Wojdyla, Guillermo J Pons-Estel, Luis J Catoggio, Cristina Drenkard, Judith Sarano, Guillermo A Berbotto, Eduardo F Borba, Emilia Inoue Sato, João C Tavares Brenol, Oscar Uribe, Luis A Ramirez Gómez, Marlene Guibert-Toledano, Loreto Massardo, Mario H Cardiel, Luis H Silveira, Rosa Chacón-Diaz, Graciela S Alarcón, Bernardo A Pons-Estel
OBJECTIVE: To evaluate disease activity statuses' (DAS') impact on systemic lupus erythematosus (SLE) outcomes. MATERIALS AND METHODS: Four DAS were defined: remission off-therapy: SLE Disease Activity Index (SLEDAI)=0, no prednisone or immunosuppressive drugs (IS); remission on-therapy: SLEDAI=0, prednisone ≤5 mg/day and/or IS (maintenance); low (L) DAS: SLEDAI ≤4, prednisone ≤7.5 mg/day and/or IS (maintenance); non-optimally controlled: SLEDAI >4 and/or prednisone >7...
December 2017: Annals of the Rheumatic Diseases
Vera Golder, Rangi Kandane-Rathnayake, Alberta Yik-Bun Hoi, Molla Huq, Worawit Louthrenoo, Yuan An, Zhan Guo Li, Shue Fen Luo, Sargunan Sockalingam, Chak Sing Lau, Mo Yin Mok, Aisha Lateef, Kate Franklyn, Susan Morton, Sandra Teresa V Navarra, Leonid Zamora, Yeong-Jian Wu, Laniyati Hamijoyo, Madelynn Chan, Sean O'Neill, Fiona Goldblatt, Mandana Nikpour, Eric Francis Morand
BACKGROUND: Systemic lupus erythematosus (SLE) is associated with significant impairment of health-related quality of life (HR-QoL). Recently, meeting a definition of a lupus low disease activity state (LLDAS), analogous to low disease activity in rheumatoid arthritis, was preliminarily validated as associated with protection from damage accrual. The LLDAS definition has not been previously evaluated for association with patient-reported outcomes. The objective of this study was to determine whether LLDAS is associated with better HR-QoL, and examine predictors of HR-QoL, in a large multiethnic, multinational cohort of patients with SLE...
March 20, 2017: Arthritis Research & Therapy
Yujuan Zhang, Diana Milojevic
Bone health in children with rheumatic conditions may be compromised due to several factors related to the inflammatory disease state, delayed puberty, altered life style, including decreased physical activities, sun avoidance, suboptimal calcium and vitamin D intake, and medical treatments, mainly glucocorticoids and possibly some disease-modifying anti-rheumatic drugs. Low bone density or even fragility fractures could be asymptomatic; therefore, children with diseases of high inflammatory load, such as systemic onset juvenile idiopathic arthritis, juvenile dermatomyositis, systemic lupus erythematosus, and those requiring chronic glucocorticoids may benefit from routine screening of bone health...
June 2017: Paediatric Drugs
Vera Golder, Molla Huq, Kate Franklyn, Alicia Calderone, Aisha Lateef, Chak Sing Lau, Alfred Lok Hang Lee, Sandra Teresa V Navarra, Timothy Godfrey, Shereen Oon, Alberta Yik Bun Hoi, Eric Francis Morand, Mandana Nikpour
OBJECTIVE: To evaluate the construct validity of the Lupus Low Disease Activity State (LLDAS), a treatment target in systemic lupus erythematosus (SLE). METHODS: Fifty SLE case summaries based on real patients were prepared and assessed independently for meeting the operational definition of LLDAS. Fifty international rheumatologists with expertise in SLE, but with no prior involvement in the LLDAS project, responded to a survey in which they were asked to categorize the disease activity state of each case as remission, low, moderate, or high...
June 2017: Seminars in Arthritis and Rheumatism
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