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https://www.readbyqxmd.com/read/28803702/patient-and-physician-reported-satisfaction-with-systemic-lupus-erythematosus-treatment-in-us-clinical-practice
#1
Katie Pascoe, Steve Lobosco, David Bell, Ben Hoskin, David J Chang, Bonnie Pobiner, Sulabha Ramachandran
PURPOSE: This two-part study comprised two descriptive, cross-sectional surveys to evaluate treatment satisfaction among patients with systemic lupus erythematosus (SLE) and their physicians from US clinical practices. The Lupus Plus Project (LPP; part one) involved belimumab-containing regimens; the Disease Specific Program (DSP; part two) included all treatments and was designed to build on the body of evidence from part one. METHODS: The LPP recruited patients receiving belimumab, and comprised 2 paper questionnaires: a patient self-completion questionnaire (PSC) and a patient record form (PRF) completed by the physician...
August 10, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28800401/lupus-nephritis-and-b-cell-targeting-therapy
#2
Matthias Cassia, Federico Alberici, Maurizio Gallieni, David Jayne
Lupus Nephritis (LN) is a severe manifestation of Systemic Lupus Erythematosus (SLE) with a significant prognostic impact. Over a prolonged course, an exhaustion of treatment alternatives may occur and further therapeutic options are needed. B cells play a pivotal role in disease pathogenesis and represent an attractive therapeutic target. Areas covered: This review provides an update regarding targeting B cell in LN. The rational for this approach, as well as currently available and future targets are discussed...
August 11, 2017: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/28795307/sex-symptom-severity-and-quality-of-life-in-rheumatology
#3
REVIEW
Marco Krasselt, Christoph Baerwald
Inflammatory rheumatic diseases such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) show a striking female predominance ranging from 3:1 in RA up to 9:1 in SLE. The background for those gender bias is not fully understood yet, but seems to be the result of a complex interaction between sex hormones, (epi-)genetics, and possibly even the composition of gut microbiota. Moreover, time of disease onset, the clinical phenotype including co-morbidities as well as the course of the diseases during life differ between genders...
August 9, 2017: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/28794515/the-complement-system-as-a-potential-therapeutic-target-in-rheumatic-disease
#4
REVIEW
Leendert A Trouw, Matthew C Pickering, Anna M Blom
Complement activation is associated with common rheumatic diseases such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and systemic vasculitis. Evidence linking complement activation to these diseases includes the presence of complement deposition in affected tissues, decreased levels of complement proteins and high levels of complement activation fragments in the blood and/or synovial fluid of patients with these diseases, as well as data from experimental models. Eculizumab, a monoclonal antibody that inhibits the complement component C5, is now approved for the treatment of rare conditions involving complement hyperactivation, and the success of this therapy has renewed interest in understanding the utility of complement inhibition in rheumatological practice, particularly for SLE...
August 10, 2017: Nature Reviews. Rheumatology
https://www.readbyqxmd.com/read/28789968/b-cell-phenotypes-signaling-and-their-roles-in-secretion-of-antibodies-in-systemic-lupus-erythematosus
#5
Yoshiya Tanaka, Satoshi Kubo, Shigeru Iwata, Maiko Yoshikawa, Shingo Nakayamada
B cells play a pivotal role in the initiation and perpetuation of SLE. Because SLE is molecularly and clinically heterogeneous, efficacious targeted therapy to clinical remission has not yet been established in SLE. We have found i) statistical clustering between Tfh cells and class-switched memory B cells and the upregulated transition from CXCR5(+) IgM memory B cells to CXCR3(+) class-switched memory B cells in SLE by 8-color flow cytometry, ii) the involvement of Syk, Btk and JAK in the activation and differentiation of B cells in SLE, iii) SLE patients was divided to 3 groups based on immunophenotypic analysis and statistical analysis and patients in the Tfh/class-switched B cell-dominant group were most refractory to conventional therapies although 3 groups had similar clinical features...
August 5, 2017: Clinical Immunology: the Official Journal of the Clinical Immunology Society
https://www.readbyqxmd.com/read/28782090/purified-umbilical-cord-derived-mesenchymal-stem-cell-treatment-in-a-case-of-systemic-lupus-erythematosus
#6
Christopher D Phillips, Pornpatcharin Wongsaisri, Thein Htut, Terry Grossman
INTRODUCTION: Systemic lupus erythematosus (SLE) is a multiple organ system autoimmune disorder for which there is no known cure. METHODS: We report a case of a young adult lady with SLE and Sjogren's with diagnostic and clinical resolution following purified umbilical cord derived mesenchymal stem cell (MSC) and globulin component protein macrophage activating factor (GcMAF) therapy in a combined multidisciplinary integrative medicine protocol. RESULTS: Our patient had complete reversal of all clinical and laboratory markers...
December 2017: Clinical and Translational Medicine
https://www.readbyqxmd.com/read/28780512/repeated-administration-of-dapirolizumab-pegol-in-a-randomised-phase-i-study-is-well-tolerated-and-accompanied-by-improvements-in-several-composite-measures-of-systemic-lupus-erythematosus-disease-activity-and-changes-in-whole-blood-transcriptomic-profiles
#7
Chris Chamberlain, Peter J Colman, Ann M Ranger, Linda C Burkly, Geoffrey I Johnston, Christian Otoul, Christian Stach, Miren Zamacona, Thomas Dörner, Murray Urowitz, Falk Hiepe
OBJECTIVES: Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease associated with diffuse immune cell dysfunction. CD40-CD40 ligand (CD40L) interaction activates B cells, antigen-presenting cells and platelets. CD40L blockade might provide an innovative treatment for systemic autoimmune disorders. We investigated the safety and clinical activity of dapirolizumab pegol, a polyethylene glycol conjugated anti-CD40L Fab' fragment, in patients with SLE. METHODS: This 32-week randomised, double-blind, multicentre study (NCT01764594) evaluated repeated intravenous administration of dapirolizumab pegol in patients with SLE who were positive for/had history of antidouble stranded DNA/antinuclear antibodies and were on stable doses of immunomodulatory therapies (if applicable)...
August 5, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28769820/inhibition-of-toll-like-receptor-signaling-as-a-promising-therapy-for-inflammatory-diseases-a-journey-from-molecular-to-nano-therapeutics
#8
REVIEW
Wei Gao, Ye Xiong, Qiang Li, Hong Yang
The recognition of invading pathogens and endogenous molecules from damaged tissues by toll-like receptors (TLRs) triggers protective self-defense mechanisms. However, excessive TLR activation disrupts the immune homeostasis by sustained pro-inflammatory cytokines and chemokines production and consequently contributes to the development of many inflammatory and autoimmune diseases, such as systemic lupus erythematosus (SLE), infection-associated sepsis, atherosclerosis, and asthma. Therefore, inhibitors/antagonists targeting TLR signals may be beneficial to treat these disorders...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28764615/cerebral-tuberculosis-in-a-patient-with-systemic-lupus-erythematosus-following-cyclophosphamide-treatment-a-case-report
#9
S Cooray, H Zhang, R Breen, G Carr-White, R Howard, M Cuadrado, D D'Cruz, G Sanna
Central nervous system (CNS) tuberculosis (TB) is a rare but catastrophic event in patients with systemic lupus erythematosus (SLE). Here we report a case of cerebral TB in a patient with lupus myocarditis and nephritis, following cyclophosphamide immunosuppression. To our knowledge this is the first reported case of cerebral TB in SLE in a non-endemic country. A 31-year-old female with SLE and a history of regular travel to Kenya presented to our centre with clinical features of acute heart failure. She was diagnosed with severe lupus myocarditis, and a renal biopsy also confirmed lupus nephritis...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28761334/concerns-of-patients-with-systemic-lupus-erythematosus-and-adherence-to-therapy-a-qualitative-study
#10
Filipa Farinha, Francisco Freitas, Ana Águeda, Inês Cunha, Anabela Barcelos
PURPOSE: The objectives of this study were 1) to identify the impact of systemic lupus erythematosus (SLE) on patients' lives and their reactions to this, as well as their main concerns and expectations regarding their disease and treatments; and 2) to assess the relationship between these concerns and the adherence to treatments, medical visits, and diagnostic tests. PATIENTS AND METHODS: Qualitative study, using a convenient sample of SLE patients attending an outpatient rheumatology clinic...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28755405/serum-ifn-%C3%AE-predicts-the-therapeutic-effect-of-mesenchymal-stem-cells-transplantation-in-systemic-lupus-erythematosus-patients
#11
Dandan Wang, Shiying Wang, Saisai Huang, Zhuoya Zhang, Xinran Yuan, Xuebing Feng, Liwei Lu, Lingyun Sun
Umbilical cord (UC) derived mesenchymal stem cells (MSCs) show immunoregulatory properties on various immune cells and display therapeutic effects on various autoimmune diseases such as systemic lupus erythematosus (SLE). The aim of this study is to investigate the effect of SLE environment on UC MSCs and to identify the possible serum biomarker to predict the therapeutic effect. UC MSCs were cocultured with peripheral blood mononuclear cells (PBMCs) from active lupus patients and the proliferation, apoptosis and surface markers of UC MSCs were observed...
July 29, 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28753077/low-dose-cyclosporine-a-in-the-treatment-of-resistant-proliferative-lupus-nephritis
#12
Marjan Sheikholeslami, Mehrzad Hajialilo, Seyed Sadreddin Rasi Hashemi, Aida Malek Mahdavi, Morteza Gojazadeh, Alireza Khabbazi
OBJECTIVE: This study aimed to evaluate long-term efficacy of low dose cyclosporine A (CsA) in the treatment of resistant proliferative lupus nephritis. METHODS: In this retrospective study, patients with biopsy proven proliferative lupus nephritis who were unresponsive to combination therapy with steroid plus mycophenolate mofetil (MMF) or cyclophosphamide (CYC) and had been treated with CsA were included. Efficacy monitoring was based on the systemic lupus erythematosus (SLE) disease activity index, dose of prednisolone, serum complement, anti-double stranded DNA (anti-dsDNA) titration, urine analysis, proteinuria, creatinine clearance, remission of the renal disease, renal survival and involvement of other organs...
July 28, 2017: Modern Rheumatology
https://www.readbyqxmd.com/read/28748881/predictive-factors-of-mortality-in-a-tunisian-cohort-with-systemic-lupus-erythematosus
#13
Amel Harzallah, Hayet Kaaroud, Mariem Hajji, Ikram Mami, Rim Goucha, Fethi Ben Hamida, Samia Barbouch, Taieb Ben Abdallah
Mortality in systemic lupus erythematosus (SLE) has decreased with the advent of immunosuppressive therapy and the development of hemodialysis. This study aims to evaluate the survival rate, factors of poor prognosis, and causes of death in SLE in a Tunisian series. The records of all SLE patients followed up in a single center during 1974-2014 were reviewed. The causes of death were identified. Prognostic factors of survival were analyzed by multivariate analysis using the comparison of the survival rates by the log-rank test...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28748509/clinical-characteristics-and-thrombosis-outcomes-of-paediatric-antiphospholipid-syndrome-analysis-of-58-patients
#14
Jingran Ma, Hongmei Song, Min Wei, Yanyan He
The study aims to analyse the clinical and immunological manifestations of paediatric antiphospholipid syndrome (APS) in patients, based on the 2006 revised classification criteria of definite APS. Fifty-eight paediatric patients with APS were enrolled and analysed retrospectively. A total of 37 female and 21 male patients with a mean age of 14 ± 3 years at disease onset were included. Fourteen (24%) cases were primary APS, and 40 (69%) cases were secondary to systemic lupus erythaematosus (SLE). Anti-nuclear antibody (ANA) positivity and hypocomplementemia were more common in secondary APS than in primary APS...
July 26, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28745239/therapeutic-interventions-of-tissue-specific-autoimmune-onset-in-systemic-lupus-erythematosus
#15
Subhajit Dasgupta
Systemic lupus erythematosus (SLE) is a female predominant autoimmune disease. The onset of SLE has been found to affect kidney, bone, cardiovascular and central nervous system. Auto activation of B cells and T helper cells together are known to develop self-reactive immune responses in SLE. The therapy still includes corticosteroids to prevent allergic manifestations and inflammatory immune responses. Recent observations suggested that, mycophenolate mofetil and cyclophosphamide treatment in combination with corticosteroids have benefit to control disease manifestations...
July 25, 2017: Mini Reviews in Medicinal Chemistry
https://www.readbyqxmd.com/read/28738696/the-role-of-autoantibodies-in-the-syndromes-of-orthostatic-intolerance-a-systematic-review
#16
Mohammed Ruzieh, Lillian Batizy, Osama Dasa, Carson Oostra, Blair Grubb
Orthostatic intolerance is defined as the provocation of symptoms upon standing, commonly caused by neurogenic orthostatic hypotension (OH) and postural tachycardia syndrome (POTS), the etiology for which has not been fully uncovered yet. Many reports have described the occurrence of dysautonomia, orthostatic intolerance and POTS following febrile illness, presumably viral and post-vaccine. Furthermore, patients with dysautonomia have higher rates of autoimmune disorders such as Hashimoto thyroiditis and SLE...
July 24, 2017: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/28734427/libman-sacks-endocarditis-due-to-systemic-lupus-erythematosus-activation-after-mitral-valve-plasty
#17
Takaaki Samura, Koichi Toda, Daisuke Yoshioka, Teruya Nakamura, Shigeru Miyagawa, Yasushi Yoshikawa, Shunsuke Saito, Keitaro Domae, Yoshiki Sawa
Libman-Sacks endocarditis is a cardiac manifestation of systemic lupus erythematosus (SLE) and antiphospholipid syndrome. We report a case of mitral valve destruction due to Libman-Sacks endocarditis, which was caused by activation of SLE, despite prompt initiation of systemic steroid therapy. The prevention of SLE activation is critically important in valve surgery for patients with SLE. To the best of our knowledge, this is the first case of repaired mitral valve destruction due to activation of SLE, which was caused by valve surgery itself...
August 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28732643/development-and-internal-validation-of-a-prediction-model-to-estimate-the-probability-of-needing-aggressive-immunosuppressive-therapy-with-cytostatics-in-de-novo-lupus-nephritis-patients
#18
Mauricio Restrepo-Escobar, Paula Andrea Granda-Carvajal, Fabián Jaimes
OBJECTIVE: To develop a multivariable clinical prediction model for the requirement of aggressive immunosuppression with cytostatics, based on simple clinical record data and lab tests. The model is defined in accordance with the result of the kidney biopsies. METHODS: Retrospective study conducted with data from patients 16 years and older, with SLE and nephritis with less than 6 months of evolution. An initial bivariate analysis was conducted to select the variables to be included in a multiple logistic regression model...
July 18, 2017: Reumatología Clinica
https://www.readbyqxmd.com/read/28728508/immunodeficiency-and-autoimmunity-coming-together-a-nearly-missed-diagnosis
#19
F T Carreiro, S Betkova, C Sepúlveda, M J Manata, O Cardoso, F Maltez, M F Moraes-Fontes
The coexistence of human immunodeficiency virus (HIV) and systemic lupus erythematosus (SLE) appears to be unusual and the prevalence of patients who carry the dual diagnosis is currently unknown. We hereby present a case of a C4 deficient HIV-1 positive Caucasian female under highly active antiretroviral therapy for the past eight years, admitted to hospital with an aggressive and potentially fatal clinical presentation of SLE. There was a favorable outcome despite a significant diagnostic delay. Despite its rarity, the case highlights that this association is remarkable and may be overlooked by clinicians familiar with either condition...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28717403/the-potential-role-of-adult-stem-cells-in-the-management-of-the-rheumatic-diseases
#20
REVIEW
Tiziana Franceschetti, Cosimo De Bari
Adult stem cells are considered as appealing therapeutic candidates for inflammatory and degenerative musculoskeletal diseases. A large body of preclinical research has contributed to describing their immune-modulating properties and regenerative potential. Additionally, increasing evidence suggests that stem cell differentiation and function are disrupted in the pathogenesis of rheumatic diseases. Clinical studies have been limited, for the most part, to the application of adult stem cell-based treatments on small numbers of patients or as a 'salvage' therapy in life-threatening disease cases...
July 2017: Therapeutic Advances in Musculoskeletal Disease
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