scholarly journals Lung Involvements in Rheumatic Diseases: Update on the Epidemiology, Pathogenesis, Clinical Features, and Treatment

2018 ◽  
Vol 2018 ◽  
pp. 1-19 ◽  
Author(s):  
You-Jung Ha ◽  
Yun Jong Lee ◽  
Eun Ha Kang
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Treatment Options ◽  
Specific Form ◽  
Lung Involvement ◽  
Systemic Lupus ◽  
The Past ◽  
History Of

Lung illness encountered in patients with rheumatic diseases bears clinical significance in terms of increased morbidity and mortality as well as potential challenges placed on patient care. Although our understanding of natural history of this important illness is still limited, epidemiologic knowledge has been accumulated during the past decade to provide useful information on the risk factors and prognosis of lung involvements in rheumatic diseases. Moreover, the pathogenesis particularly in the context of genetics has been greatly updated for both the underlying rheumatic disease and associated lung involvement. This review will focus on the current update on the epidemiologic and genetics features and treatment options of the lung involvements associated with four major rheumatic diseases (rheumatoid arthritis, systemic sclerosis, myositis, and systemic lupus erythematosus), with more attention to a specific form of involvement or interstitial lung disease.

scholarly journals Chloroquine and Hydroxychloroquine Toxicity

2020 ◽  
Vol 2 ◽  
pp. 8 ◽  
Author(s):  
Weilin Song ◽  
Justin C. Muste ◽  
Tyler E. Greenlee ◽  
Rishi P. Singh
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Retinal Toxicity ◽  
Fundus Examination ◽  
Potential Complication ◽  
Systemic Lupus ◽  
Additional Risk

Chloroquine and hydroxychloroquine have been used for decades as antimalarials and also as immunomodulating therapies for rheumatic diseases such as systemic lupus erythematosus and rheumatoid arthritis. They also have antiviral properties and are currently used empirically for the treatment of coronavirus disease 2019 (COVID-19). Retinal toxicity is a potential complication of these medications. Current ophthalmic screening and dosing recommendations aim to decrease the risk of developing retinopathy or prevent its progression. Baseline fundus examination is not currently recommended before initiating chloroquine or hydroxychloroquine for COVID-19 due to presumed very low risk of retinal toxicity. However, doses of the drugs used for the treatment of COVID-19 exceed the recommended doses, and patients often have additional risk factors. Research in the future is warranted to confirm the risk and incidence of toxicity with this novel use.

scholarly journals Semiquantified Noncalcified Coronary Plaque in Systemic Lupus Erythematosus

2012 ◽  
Vol 39 (12) ◽  
pp. 2286-2293 ◽  
Author(s):  
ADNAN N. KIANI ◽  
JENS VOGEL-CLAUSSEN ◽  
ARMIN ARBAB-ZADEH ◽  
LAURENCE S. MAGDER ◽  
JOAO LIMA ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Lupus Erythematosus ◽  
Univariate Analysis ◽  
Coronary Plaque ◽  
Systemic Lupus ◽  
History Of ◽  
Noncalcified Plaque

Objective.A major cause of morbidity and mortality in systemic lupus erythematosus (SLE) is accelerated coronary atherosclerosis. New technology (computed tomographic angiography) can measure noncalcified coronary plaque (NCP), which is more prone to rupture. We report on a study of semiquantified NCP in SLE.Methods.Patients with SLE (n = 147) with no history of cardiovascular disease underwent 64-slice coronary multidetector computed tomography (MDCT). The MDCT scans were evaluated quantitatively by a radiologist, using dedicated software.Results.The group of 147 patients with SLE was 86% female, 70% white, 29% African American, and 3% other ethnicity. The mean age was 51 years. In our univariate analysis, the major traditional cardiovascular risk factors associated with noncalcified plaque were age (p = 0.007), obesity (p = 0.03; measured as body mass index), homocysteine (p = 0.05), and hypertension (p = 0.04). Anticardiolipin (p = 0.026; but not lupus anticoagulant) and anti-dsDNA (p = 0.03) were associated with higher noncalcified plaque. Prednisone and hydroxychloroquine therapy had no effect, but methotrexate (MTX) use was associated with higher noncalcified plaque (p = 0.0001). In the best multivariate model, age, current MTX use, and history of anti-dsDNA remained significant.Conclusion.Our results suggest that serologic SLE (anti-dsDNA) and traditional cardiovascular risk factors contribute to semiquantified noncalcified plaque in SLE. The association with MTX is not understood, but should be replicated in larger studies and in multiple centers.

scholarly journals Diet in Rheumatoid Arthritis versus Systemic Lupus Erythematosus: Any Differences?

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 772
Author(s):  
Alessia Alunno ◽  
Francesco Carubbi ◽  
Elena Bartoloni ◽  
Davide Grassi ◽  
Claudio Ferri ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Musculoskeletal Diseases ◽  
Normal Subjects ◽  
Experimental Models ◽  
Systemic Lupus ◽  
History Of ◽  
Indirect Action

In recent years, an increasing interest in the influence of diet in rheumatic and musculoskeletal diseases (RMDs) led to the publication of several articles exploring the role of food/nutrients in both the risk of developing these conditions in normal subjects and the natural history of the disease in patients with established RMDs. Diet may be a possible facilitator of RMDs due to both the direct pro-inflammatory properties of some nutrients and the indirect action on insulin resistance, obesity and associated co-morbidities. A consistent body of research has been conducted in rheumatoid arthritis (RA), while studies in systemic lupus erythematosus (SLE) are scarce and have been conducted mainly on experimental models of the disease. This review article aims to outline similarities and differences between RA and SLE based on the existing literature.

scholarly journals Hydroxychloroquine

2020 ◽  
Vol 0 ◽  
pp. 1-7
Author(s):  
C. B. Sindhu ◽  
Sandhya George ◽  
Anita Sankar ◽  
Valsa Stephen
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Adverse Effects ◽  
Drug Administration ◽  
Lupus Erythematosus ◽  
Food And Drug Administration ◽  
Systemic Lupus ◽  
The Past ◽  
Related Drug

Hydroxychloroquine (HCQ) and its related drug, chloroquine, have been under use for malaria for the past 75 years. Its use for malaria, rheumatoid arthritis and systemic lupus erythematosus are Food and Drug Administration (FDA) approved. These drugs have immunomodulatory and antiviral actions. More and more indications for this drug are being explored. These drugs are still under study as possible treatments for coronavirus disease 2019 but at present FDA has revoked its emergency use authorization for these two drugs. However, in many other indications, HCQ is a valuable drug but monitoring for adverse effects is mandatory.

scholarly journals Pseudo-pseudo Meigs’ syndrome: a rare presentation of systemic lupus erythematosus

Reumatismo ◽  
2019 ◽  
Vol 71 (2) ◽  
pp. 108-112 ◽  
Author(s):  
G. Tansir ◽  
P. Kumar ◽  
A. Pius ◽  
S.K. Sunny ◽  
M. Soneja
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Pleural Effusion ◽  
Autoimmune Disease ◽  
Lupus Erythematosus ◽  
Abdominal Distension ◽  
Ca 125 ◽  
Systemic Lupus ◽  
Rare Presentation ◽  
The Past ◽  
History Of

Systemic lupus erythematosus (SLE) is a chronic inflammatory multisystem autoimmune disease. Ascites when associated with pleural effusion and raised CA-125 levels in SLE patient, is known as pseudo-pseudo Meigs’ syndrome (PPMS). This is the case of a 22-year-old lady who presented with complaints of abdominal distension for one month and had a history of spontaneous abortion in the past. Abdominal imaging did not reveal any tumor and after extensive workup a diagnosis of PPMS was made. She was successfully treated with steroids, hydroxychloroquine and cyclophosphamide.

scholarly journals Risk and protective factors for thrombosis in systemic lupus erythematosus: results from a large, multi-ethnic cohort

2008 ◽  
Vol 68 (2) ◽  
pp. 238-241 ◽  
Author(s):  
R Kaiser ◽  
C M Cleveland ◽  
L A Criswell
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Asian Americans ◽  
Lupus Erythematosus ◽  
Disease Duration ◽  
Medication Use ◽  
Small Sample ◽  
Antiphospholipid Antibody ◽  
Systemic Lupus ◽  
History Of

Objectives:Few studies have examined thrombosis in systemic lupus erythematosus (SLE), none have included Asian-Americans, and most have had small sample sizes. We analysed risk factors for thrombosis in a large, multi-ethnic SLE cohort.Methods:We studied 1930 SLE subjects, including Caucasians, African-Americans, Asian-Americans and Hispanics. Data were derived from questionnaires and medical records. Documented history of thrombosis was the primary outcome. Explanatory variables included age at SLE diagnosis, gender, ethnicity, disease duration, smoking, antiphospholipid antibody (aPL) status, nephritis and specific medications.Results:Smoking (OR 1.26, p = 0.011), longer disease duration (OR 1.26 per 5 years p = 0.027×10−7), nephritis (OR 1.35, p = 0.036), aPL positivity (OR 3.22, p<10−9) and immunomodulating medication use (OR 1.40, p = 0.011) were statistically significant risk factors for thrombosis. Younger age at SLE onset was protective (OR 0.52 for age ⩽20, p = 0.001). After adjusting for disease severity and incorporating propensity scores, hydroxychloroquine use remained significantly protective for thrombosis (OR 0.62, p = 4.91×10−4).Conclusions:This study confirms that older age at onset, longer disease duration, smoking, aPL positivity, history of nephritis and immunomodulating medication use are risk factors for thrombosis in SLE. These data are the first to confirm in a large and ethnically diverse SLE cohort that hydroxychloroquine use is protective for thrombosis.

scholarly journals Pharmacovigilance of Biopharmaceuticals in Rheumatic Diseases, Adverse Events, Evolution, and Perspective: An Overview

Biomedicines ◽  
2020 ◽  
Vol 8 (9) ◽  
pp. 303
Author(s):  
Sandra Rodríguez ◽  
Andrés Muñoz ◽  
Rosa-Helena Bustos ◽  
Diego Jaimes
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Adverse Events ◽  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Cell Mediated Immunity ◽  
Systemic Lupus ◽  
Biological Drugs ◽  
Necrosis Factor Alpha ◽  
Post Marketing

Since we have gained an understanding of the immunological pathophysiology of rheumatic diseases such as rheumatoid arthritis and systemic lupus erythematosus, treatment based on biological drugs has become a fundamental axis. These therapies are oriented towards the regulation of cytokines such as tumour necrosis factor-alpha (TNF-α), interleukin (IL)-6, IL-1, and the modulation of cell-mediated immunity (B cells and T cells) by anti CD20 or anti CTAL-4 agents, and can increase the risk of associated infections or adverse events (AE). In this context, the entry of biotherapeutics represented a challenge for pharmacovigilance, risk management and approval by the main global regulatory agencies regarding biosimilars, where efficacy and safety are based on comparability exercises without being an exact copy in terms of molecular structure. The objective of this review is divided into three fundamental aspects: (i) to illustrate the evolution and focus of pharmacovigilance at the biopharmaceutical level, (ii) to describe the different approved recommendations of biopharmaceuticals (biological and biosimilars) and their use in rheumatic diseases (RDs) such as rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), systemic lupus erythematosus (SLE) and other less frequent RD like cryopyrin-associated autoinflammatory syndromes (CAPS), and (iii) to identify the main AE reported in the post-marketing phase of RD biopharmaceuticals.

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