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REVIEW
Alberta Hoi, Talia Igel, Chi Chiu Mok, Laurent Arnaud
Systemic lupus erythematosus (SLE) is a multisystemic autoimmune disease characterised by the presence of autoantibodies towards nuclear antigens, immune complex deposition, and chronic inflammation at classic target organs such as skin, joints, and kidneys. Despite substantial advances in the diagnosis and management of SLE, the burden of disease remains high. It is important to appreciate the typical presentations and the diagnostic process to facilitate early referral and diagnosis for patients. In most patients, constitutional, mucocutaneous, and musculoskeletal symptoms represent the earliest complaints; these symptoms can include fatigue, lupus-specific rash, mouth ulcers, alopecia, joint pain, and myalgia...
April 17, 2024: Lancet
#2
JOURNAL ARTICLE
Yusuke Ueda, Tomoyuki Sakai, Kazunori Yamada, Kotaro Arita, Yoko Ishige, Daisuke Hoshi, Hiroto Yanagisawa, Haruka Iwao-Kawanami, Takafumi Kawanami, Shuichi Mizuta, Toshihiro Fukushima, Sohsuke Yamada, Akihiro Yachie, Yasufumi Masaki
Hemophagocytic lymphohistiocytosis (HLH) has been recognized as a rare adverse event following the coronavirus disease 2019 (COVID-19) vaccination. We report a case of neuropsychiatric symptoms and refractory HLH in a woman with systemic lupus erythematosus (SLE) after receiving her COVID-19 vaccine treated with belimumab, later found to have intravascular large B-cell lymphoma (IVLBCL) at autopsy. A 61-year-old woman with SLE was referred to our hospital because of impaired consciousness and fever. One month prior to consulting, she received her second COVID-19 vaccine dose...
April 15, 2024: Immunological Medicine
#3
JOURNAL ARTICLE
Chiara Tani, Dina Zucchi, Chiara Cardelli, Elena Elefante, Viola Signorini, Davide Schilirò, Giancarlo Cascarano, Luca Gualtieri, Anastasiya Valevich, Giulia Puccetti, Linda Carli, Chiara Stagnaro, Marta Mosca
OBJECTIVE: The objective is to evaluate perscriptions of belimumab (BEL), how these have changed over the years and their impact on clinical outcomes in patients with systemic lupus erythematosus (SLE). METHODS: This is a retrospective analysis of prospectively collected data. We retrieved demographic and clinical data and concomitant therapies at BEL starting (baseline). Disease activity was assessed at baseline and after 6 and 12 months and organ damage at baseline and at the last visit...
April 12, 2024: RMD Open
#4
JOURNAL ARTICLE
Scott E Wenderfer, Jennifer C Cooper
A 14-year-old patient presents with hematuria and proteinuria. Clinical evaluation reveals a positive anti-nuclear antibody titer, positive anti-double stranded DNA antibody and hypocomplementemia. Systemic lupus erythematosus (SLE) is diagnosed based on the 2019 EULAR/ACR (European League Against Rheumatism/American College of Rheumatology) classification criteria (Aringer et al. Arthritis Rheumatol 71:1400-1412, 2019). A kidney biopsy is performed that confirms the presence of immune complex glomerulonephritis, ISN-RPS (International Society of Nephrology/Renal Pathology Society) class IV (Bajema et al...
April 12, 2024: Pediatric Nephrology
#5
JOURNAL ARTICLE
Rashmi Dhital, Neha Chiruvolu Singh, Andrea M Spiker, Dilli Ram Poudel, Brian Pedersen, Christie M Bartels
OBJECTIVE: Avascular necrosis (AVN) is a devastating complication often necessitating arthroplasty, particularly common in systemic lupus erythematosus (SLE). Limited research exists on arthroplasty trends since new steroid-sparing agents. We analyzed trends and characteristics associated with AVN and AVN-related arthroplasties among SLE and RA hospitalizations using two decades of data from the U.S. National Inpatient Sample (NIS). METHODS: This cross-sectional study used NIS (2000-2019) to identify hospitalized adults with SLE and RA, with or without AVN, using ICD codes...
April 10, 2024: Seminars in Arthritis and Rheumatism
#6
JOURNAL ARTICLE
Naoto Azuma, Masaru Natsuaki, Naoaki Hashimoto, Takeo Abe, Suzu Ueda, Yuko Ohno, Masatoshi Jinnin, Kiyoshi Matsui
Alopecia associated with lupus erythematosus is broadly classified into reversible nonscarring alopecia seen in the acute phase, such as worsening of systemic lupus erythematosus (SLE) and cicatricial alopecia seen in chronic cutaneous lupus erythematosus represented by discoid lupus erythematosus (DLE). In DLE-induced alopecia, early therapeutic intervention before developing scarring alopecia is important, but the condition is often resistant to conventional treatment. Anifrolumab (ANI), a novel therapeutic agent for SLE that inhibits type I interferon activity, has been shown to be effective against acute skin lesions, including alopecia, in patients with SLE...
April 10, 2024: Modern rheumatology case reports
#7
JOURNAL ARTICLE
Paloma Vela-Casasempere, Rocío Caño Alameda, Silvia Gómez Sabater, Silvia Cortell Aznar, Encarnación Pérez Pascual
OBJECTIVE: To share our experience with belimumab in lupus pregnant women and to review the relevant published literature on its use in this scenario. METHODS: A prospective observational study of pregnant patients with lupus was conducted. Additionally, MEDLINE and EMBASE databases were searched, and a secondary hand search of the literature was performed. Studies were evaluated and visualised descriptively. RESULTS: Sixteen pregnancies of 12 lupus women were included, six (involving eight pregnancies) received belimumab throughout their illness, five of them during some period of gestation...
April 9, 2024: Lupus
#8
JOURNAL ARTICLE
Caroline H Siegel, Lisa R Sammaritano
IMPORTANCE: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by inflammation and immune-mediated injury to multiple organ systems, including the mucocutaneous, musculoskeletal, hematologic, and kidney systems. Approximately 3.4 million people worldwide have received a diagnosis of SLE. OBSERVATIONS: Approximately 90% of people with SLE are female. Although there are no uniformly accepted diagnostic criteria for SLE, the 2019 European Alliance of Associations for Rheumatology (formerly the European League Against Rheumatism)/American College of Rheumatology classification criteria developed for scientific study are an estimated 96...
April 8, 2024: JAMA
#9
JOURNAL ARTICLE
Rebecca S Treger, Susan L Fink
No abstract text is available yet for this article.
April 6, 2024: Clinical Chemistry
#10
JOURNAL ARTICLE
Guillaume Germain, Karen Worley, Sean D MacKnight, Bernard Rubin, Christopher F Bell, François Laliberté, Ana Urosevic, Mei Sheng Duh, Andrew Concoff
OBJECTIVE: To investigate the real-world impact of intravenous belimumab treatment among patients with SLE using rheumatoid arthritis-derived disease activity measures and SLE-related laboratory values. METHODS: This retrospective cohort study used US electronic medical record data from the United Rheumatology Normalised Integrated Community Evidence (UR-NICE) database. Adult patients with SLE who initiated intravenous belimumab between 1 January 2012 and 3 December 2019 (index), had 12 months of pre-index and 24 months of post-index clinical activity, and had ≥6 infusions of belimumab during the 24 months post-index were included...
April 3, 2024: Lupus Science & Medicine
#11
REVIEW
Yi Zhou, Zhangxue Hu
The interleukin (IL)-17 axis is involved in many inflammatory and autoimmune diseases. Secukinumab, an IL-17 inhibitor, has been approved for psoriasis treatment. There are accumulating cases of lupus erythematosus induced by IL-17 inhibition. Lupus nephritis after IL-17 inhibition has not been reported. We report the case of a 57-year-old man who developed membranous lupus nephritis after secukinumab treatment for psoriasis. Anti-SSA and PM-Scl antibodies were positive. dsDNA, anti-Smith, and anti-histone antibodies were negative, and serum complement was low...
May 2024: Lupus
#12
JOURNAL ARTICLE
Thomas J Tull, Emma C Benton, Kristina Semkova, Natalie A Watson, John B Mee, Begona Lopez, Jane Setterfield, Barbara Carey, Sajjad Ajmad, Scott J Robbie, Richard W Groves, Giovanni Sanna, David P D'Cruz
No abstract text is available yet for this article.
April 2, 2024: British Journal of Dermatology
#13
JOURNAL ARTICLE
Monica Simeoni, Shuying Yang, Debra J Tompson, Richard Dimelow
Belimumab was approved for active lupus nephritis (LN) in adults in the European Union and patients ≥ 5 years of age in the USA based on a Phase 3, double-blind, placebo-controlled, 104-week study. The study evaluated the efficacy of belimumab plus background standard therapy in adults with active LN using an intravenous (IV) dose of 10 mg/kg. A longitudinal analysis of Primary Efficacy Renal Response (PERR) and Complete Renal Response (CRR) was performed to assess whether patients with high proteinuria at the start of belimumab treatment would benefit from a higher dose...
March 29, 2024: Journal of Pharmacokinetics and Pharmacodynamics
#14
REVIEW
Ruth Xian Lynn Yap, Yi Wye Lai, Chang Wei, Joel Jia Wei Ng, Dan Xu, Shuo Feng, Rong Mu, Bernard Yu-Hor Thong, Chuanhui Xu
Coronavirus disease 2019 (COVID-19) vaccination is essential for patients with autoimmune inflammatory rheumatic diseases (AIIRD) to reduce the risk of morbidity and mortality associated with serious COVID-19 infection. With endemicity, waning of vaccine- and infection-acquired immunity, and development of SARS-CoV-2 variants, the need for additional doses of vaccines against serious illness in high-risk immunocompromised persons remains imperative. This review examines how immunomodulatory therapies affect vaccine-induced immune response in patients with AIIRD...
March 6, 2024: Vaccines
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JOURNAL ARTICLE
Qi Wu, Ming-Xue Zhao, Xiao-Shan Huang, Chang-Song Lin, Qiang Xu
OBJECTIVE: The objective of this study is to provide a description of a group of retrospective cohort outcomes in patients with systemic lupus erythematosus (SLE) complicated with immune thrombocytopenia (ITP) receiving belimumab. METHODS: This study reports on the treatment of 10 female patients (mean age 34.3 ± 14.0 years, mean weight 58.7 ± 18.2 kg) with both SLE and ITP who received belimumab in addition to basic drug therapy. The belimumab treatment regimen consisted of a dosage of 10 mg/kg, with an initial infusion every 2 weeks for the first 3 doses, followed by an infusion every 4 weeks...
March 22, 2024: Lupus
#16
JOURNAL ARTICLE
Chisato Yoshijima, Yosuke Suzuki, Ayako Oda, Ryota Tanaka, Hiroyuki Ono, Hiroki Itoh, Keiko Ohno
BACKGROUND: Belimumab is the first antibody drug approved for systemic lupus erythematosus (SLE), and is a fully human monoclonal antibody that inhibits soluble B lymphocyte stimulator protein. In clinical trials, a composite index was used to assess efficacy of belimumab. However, clinical guidelines on SLE treatment currently use single efficacy indexes. OBJECTIVE: The main objective of this study was to perform a meta-analysis to evaluate the efficacy of belimumab utilizing single indexes used in routine clinical practice, rather than the composite efficacy index used in clinical trials during the development phase...
2024: Current Therapeutic Research, Clinical and Experimental
#17
JOURNAL ARTICLE
Anastasia-Georgia Dedemadi, Christina Gkolfinopoulou, Dimitra Nikoleri, Myrto Nikoloudaki, Hanna Ruhanen, Minna Holopainen, Reijo Kakela, Georgia Christopoulou, Stavros Bournazos, Pantelis Constantoulakis, Prodromos Sidiropoulos, George Bertsias, Angeliki Chroni
OBJECTIVE: Chronic inflammatory diseases, like Systemic Lupus Erythematosus (SLE), carry an increased risk for atherosclerosis and cardiovascular events, accompanied by impairment of atheroprotective properties of high-density lipoprotein (HDL). In SLE, serum BAFF (B cell-activating factor), a cytokine implicated in disease progression, has been correlated with subclinical atherosclerosis. We investigated the impact of treatment with belimumab -an anti-BAFF monoclonal antibody- on HDL atheroprotective properties and composition in SLE patients...
March 21, 2024: Rheumatology
#18
JOURNAL ARTICLE
Takashi Yamane, Akira Hashiramoto
OBJECTIVES: For appropriate glucocorticoid (GC) reduction, we investigated the optimal strategy including baseline factors that could reduce GC more than 50% with 96 weeks of belimumab. METHODS: This is a retrospective cohort study of Kakogawa Central City hospital from 2019 to 2023. We identified SLE patients who were receiving 200 mg of belimumab weekly by subcutaneous injection for 96 weeks. The background at baseline, trends in clinical indicators, and factors involved in GC reduction were statistically analyzed...
May 2024: Lupus
#19
REVIEW
Lillian Xie, Lais Lopes Almeida Gomes, Caroline J Stone, Daniella Forman Faden, Victoria P Werth
Cutaneous lupus erythematosus (CLE) comprises dermatologic manifestations that may occur independently or with systemic lupus erythematosus (SLE). Despite advancements in refining CLE classification, establishing precise subtype criteria remains challenging due to overlapping presentations and difficulty in distinguishing morphology. Current treatments encompass preventive measures, topical therapies, and systemic approaches. Hydroxychloroquine and glucocorticoids are the sole US Food and Drug Administration (FDA)-approved medications for CLE, with numerous off-label treatments available...
March 15, 2024: Journal of Dermatology
#20
JOURNAL ARTICLE
Irene Altabás-González, José María Pego-Reigosa, Coral Mouriño, Norman Jiménez, Andrea Hernández-Martín, Ivette Casafont-Solé, Judit Font Urguelles, José Andrés Román-Ivorra, Marta de la Rubia Navarro, María Galindo-Izquierdo, Tarek Carlos Salman-Monte, Javier Narváez, Paola Vidal-Montal, María Jesús García-Villanueva, Sandra Garrote-Corral, María Ángeles Blázquez-Cañamero, Carlos Marras, María Piqueras-García, Julia Martínez-Barrio, Marina Sánchez-Lucas, Josefina Cortés-Hernández, Eleonora Penzo, Jaime Calvo, Juan Ramón de Dios, Belén Álvarez Rodríguez, Margarida Vasques-Rocha, Eva Tomero, Raúl Menor-Almagro, Myriam Gandía, José A Gómez-Puerta, Beatriz Frade-Sosa, Consuelo Ramos-Giráldez, Carmen Trapero-Pérez, Elvira Diez, Clara Moriano, Alejandro Muñoz-Jiménez, Iñigo Rúa-Figueroa
OBJECTIVES: To provide an overview on the current use of belimumab (BLM) in SLE patients in clinical practice and to examine its efficacy in terms of standardized outcomes, drug survival, as well as patient and safety profiles. METHODS: A longitudinal retrospective multicentre cohort including SLE patients treated with BLM at 18 Spanish centers. Data was collected upon initiation of BLM, at 6 and 12 months after initiation, and at the last recorded visit...
March 15, 2024: Rheumatology
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