scholarly journals Tyrosine-Based Monitoring of Glucocorticoid Therapy of Systemic Lupus Erythematosus

10.5772/27911 ◽  
2012 ◽  
Author(s):  
I. T.
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Glucocorticoid Therapy ◽  
Systemic Lupus

scholarly journals Monitoring of serum TWEAK levels guides glucocorticoid dosages in the treatment of systemic lupus erythematosus

2019 ◽  
Author(s):  
Jingyun Chen ◽  
Huixia Wang ◽  
Yi Wu ◽  
Xiaokang Wu ◽  
Li Wang ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Activity Index ◽  
White Blood Cells ◽  
Cutaneous Lupus Erythematosus ◽  
Glucocorticoid Therapy ◽  
Discoid Lupus Erythematosus ◽  
Systemic Lupus ◽  
Serum Samples

Abstract Background Accurate assessment of systemic lupus erythematosus (SLE) disease activity is critical. Currently existing indices or measures for assessment are either expensive, intricate, or inaccurate. The novel indices with higher sensitivity and specificity have become one of the aims of the investigators. This study was designed to explore the relationship between serum tumor necrosis factor-like weak inducer of apoptosis (TWEAK) and systemic lupus erythematosus disease activity index (SLEDAI) as well as its role in guiding glucocorticoid dosages in the treatment of SLE. Of 59 patients with SLE, 20 patients with subacute cutaneous lupus erythematosus (SCLE), 13 patients with discoid lupus erythematosus (DLE) and 32 healthy volunteers, soluble TWEAK level was determined in both serum and urine. Monomeric C-reactive protein, antinuclear antibody, interleukin 6, complements, erythrocyte sedimentation rate, and white blood cells were measured in serum samples. Moreover, SLEDAI-2K was used for evaluating the disease. Finally, methylprednisolone was administrated orally to SLE patients with the doses depending on serum TWEAK levels. Results We found that serum TWEAK levels are higher in patients with SLE (383.0 ± 45.37 ng/ml, p < 0.001 for both) or SCLE (129.1 ± 25.73 ng/ml, p < 0.05 for both) than in patients with DLE (78.38 ± 22.85 ng/ml) or in healthy controls (78.38 ± 22.85 ng/ml). Also, serum TWEAK levels correlate positively with SLEDAI-2K in patients with SLE (r2 = 0.101, p < 0.001), whereas urine TWEAK levels reflect renal damage in patients with lupus nephritis. Moreover, serum TWEAK levels had a higher correlation coefficient with SLEDAI-2K scores compared with the other serum parameters. Furthermore, TWEAK-based glucocorticoid therapy is associated with lower SLEDAI-2K scores and fewer flares in patients with SLE. Conclusions Serum TWEAK is a useful biomarker reflecting SLE disease, and monitoring of serum TWEAK levels can improve the outcomes of glucocorticoid therapy for patients with SLE.

scholarly journals Risk Factors of Glucocorticoid-Induced Diabetes Mellitus in Systemic Lupus Erythematosus

2013 ◽  
Vol 2 (2) ◽  
pp. 39-43
Author(s):  
Mojdeh Zabihi Yeganeh ◽  
Saeideh Sadeghi
Keyword(s):  
Diabetes Mellitus ◽  
Systemic Lupus Erythematosus ◽  
Mycophenolate Mofetil ◽  
Family History ◽  
Old Age ◽  
Lupus Erythematosus ◽  
Glucocorticoid Therapy ◽  
High Dose ◽  
Systemic Lupus ◽  
History Of

Background: The aim of this study was to investigate the prevalence and associated factors of glucocorticoid-induced Diabetes mellitus (GIDM) in patients with systemic lupus erythematosus (SLE) under glucocorticoid therapy.Methods: Patients with SLE who had received high-dose glucocorticoid therapy (prednisolone≥1 mg/kg/day) at Rasoul Akram and Firoozgar hospitals were recruited during 2006-2011.Results: A total of 81 patients with SLE were evaluated. 21 patients (25.9%) of them developed GIDM after high-dose glucocorticoid therapy. Univariate analysis of data showed that old age, family history of diabetes mellitus (DM) and use of Mycophenolate mofetil were factors that would increase the likelihood of GIDM.Conclusion: In summary, GIDM was developed among 25.9% of patients with SLE after high-dose glucocorticoid therapy. Old age, family history of DM and use of Mycophenolate mofetil were determined to be factors responsible for increasing the risk of developing GIDM.

scholarly journals Articular involvement, steroid treatment and fibromyalgia are the main determinants of patient-physician discordance in systemic lupus erythematosus

2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Elena Elefante ◽  
Chiara Tani ◽  
Chiara Stagnaro ◽  
Viola Signorini ◽  
Alice Parma ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Disease Duration ◽  
Glucocorticoid Therapy ◽  
Joint Involvement ◽  
Systemic Lupus ◽  
Low Disease Activity ◽  
Activity State ◽  
Active Disease

Abstract Background Remission or the lowest possible disease activity is the main target in the management of systemic lupus erythematosus (SLE). Anyway, conflicting data are present in the literature regarding the correlation between physician-driven definitions and patient perception of the disease. The objective of this study is to evaluate the relationship between the definition of lupus low disease activity state (LLDAS) and patient’s health-related quality of life (HRQoL). Methods This is a cross-sectional, monocentric study. Adult SLE patients were included. For each patient, demographics, disease duration, medications, comorbidities, organ damage, active disease manifestations and SELENA-SLEDAI were assessed. Patients have been categorised as follows: LLDAS, remission and active disease. Each patient completed the following patient-reported outcomes (PROs): SF-36, LIT, FACIT-Fatigue and SLAQ. A SLAQ score < 6 (25° percentile of our cohort) was used as the cut-off value to define a low disease activity state according to patient self-evaluation. Results We enrolled 259 consecutive SLE patients (mainly female and Caucasian, mean age 45.33 ± 13.14 years, median disease duration 14 years). 80.3% were in LLDAS, of whom 82.2% were in remission; 19.7% were active. No differences emerged for any of the PROs used between the LLDAS and the active group. Considering the LLDAS subgroup, we identified 56 patients with a subjective low disease activity (SLAQ < 6) and we defined them as “concordant”; the remaining 152 patients in LLDAS presented a subjective active disease (SLAQ ≥ 6) and were defined “discordant”. Discordant patients presented more frequently ongoing and past joint involvement (p < 0.05) and a diagnosis of fibromyalgia (p < 0.01); furthermore, they were more likely to be on glucocorticoid therapy (p < 0.01). Discordant patients showed a significantly poorer HRQoL, assessed by all PROs (p < 0.0001). Conclusions Joint involvement, glucocorticoid therapy and comorbid fibromyalgia resulted to be the most important variables determining the poor concordance between patient and physician perspective on the disease.

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