SLEuro Today

SLEuro Today

Literature Highlights - December 2019

Toward a novel prediction marker in SLE?

Comment on: Alexis Mathian, Suzanne Mouries-Martin, Karim Dorgham et al. Ultrasensitive serum interferon-α quantification during SLE remission identifies patients at risk for relapse. Ann Rheum Dis 2019;0:1–8. doi:10.1136/annrheumdis-2019-215571.
Commented by: Carlo Chizzolini, University of Geneva | UNIGE, Division of Immunology and Allergology.

The importance in SLE pathogenesis of type-I interferon (IFN-I) has been well documented and therapeutic strategies targeting IFN-I in SLE are currently being tested in clinical trials with promising results.

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Being in the right place at the right time: when position matters

Comment on: Burke et al., “Autoimmune pathways in mice and humans are blocked by pharmacological stabilization of the TYK2 pseudokinase domain.” Sci. Transl. Med. 11, eaaw1736 (2019)
Commented by: Andrea Doria, Mariele Gatto, Unit of Rheumatology, University of Padova, Italy. Email: adoria@unipd.it

The advent of small molecules in the treatment of rheumatic diseases is part of a revolution involving modulation of perturbed endogenous pathways with the aim of restoring the immune homeostasis.

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Literature Highlights - September 2019

2019 EULAR/ACR SLE classification criteria in practice

Comment on: Aringer M., Costenbader K., Daikh D., et al. “2019 European League against Rheumatism/American College of rheumatology classification criteria for systemic lupus erythematosus” Ann Rheum Dis 2019;78:1151–9. Papers 1-11.
Commented by: Matthias Schneider, Heinrich-Heine-Universität Düsseldorf, HHU, Policlinic and Hiller Research Unit Rheumatology. E-mail: Matthias.Schneider@med.uni-duesseldorf.de

The new EULAR/ACR are published and will change the perspective on lupus in many aspects (1,2). This new concept of preselection by positive ANA is challenging the ANA determination (3). Although the criteria are validated during the developing process with high values for both sensitivity and specificity, it is the duty of the scientific lupus community to analyse their value in various aspects of care and especially trials.

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EULAR recommendations for the management of antiphospholipid syndrome in adults

Comment on: Aringer M., Costenbader K., Daikh D., et al. “2019 European League against Rheumatism/American EULAR recommendations for the management of antiphospholipid syndrome in adults. Tektonidou MG, et al. Ann Rheum Dis. 2019;78:1296-1304.
Commented by: Maria G. Tektonidou, MD, PhD, Associate Professor of Rheumatology. Head of Rheumatology Unit, First Department of Propaedeutic Internal Medicine, School of Medicine, University of Athens, Greece

Due to the rarity of Antiphospholipid syndrome (APS), its complex pathogenesis, heterogeneous clinical presentation [1] and the lack of high-quality randomized clinical trials, the formulation of guidelines for the management of APS has been both a dire necessity and a difficult task.

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Tubular cell and keratinocyte single-cell transcriptomics in lupus nephritis

Comment on: Tubular cell and keratinocyte single-cell transcriptomics applied to lupus nephritis reveal type I IFN and fibrosis relevant pathways. Dar E, et al. Nat Immunol. 2019;20:915-927.
Commented by: Maria G. Tektonidou, MD, PhD, Associate Professor of Rheumatology. Head of Rheumatology Unit, First Department of Propaedeutic Internal Medicine, School of Medicine, University of Athens, Greece

Growing evidence has shown an increased expression of type I interferon (IFN) signature-regulated genes in blood and tissue cells from patients with SLE and mouse models, and IFN levels have been associated with disease flares in lupus nephritis (LN)(1, 2).

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Literature Highlights - July 2019

Low disease activity versus remission in SLE: is it ok to be "mediocre"?

Comment on: Petri M, Madger LS. Comparison of Remission and Lupus Low Disease Activity State in Damage Prevention in a United States Systemic Lupus Erythematosus Cohort. Arthritis Rheum 2018; 1790–1795
Commented by: Laurent Arnaud, Department of Rheumatology, National Reference Centre for Rare Systemic and Autoimmune Diseases East South-West (RESO), Strasbourg, France. Twitter: @Lupusreference. Email: Laurent.arnaud@chru-strasbourg.fr

Disease activity is defined as reversible manifestation. By contrast, damage is defined as irreversible manifestations that may result from the disease itself or side-effects of treatments. In systemic lupus erythematosus (SLE), disease activity has been shown to lead to long-term organ damage. Therefore, one aim of the Treat-to-target (T2T) strategy in SLE is to reach remission, or alternatively low disease activity when remission cannot be achieved [1].

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2019 update of the EULAR recommendations for the management of systemic lupus erythematosus

Comment on: Fanouriakis A, et al. 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus. Ann Rheum Dis 2019;78:736-45.
Commented by: Nathalie Costedoat-Chalumeau, Internal Medicine Department, Cochin Hospital, Referral center for rare autoimmune and systemic diseases, Paris, France.

The 2008 EULAR recommendations for the management of systemic lupus erythematosus (SLE) have been updated in 2019 [1], using a classical methodology (systematic literature review, followed by modified Delphi method to form questions, elicit expert opinions and reach consensus).
Here we summarize and discuss the main points.

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Is SLE-DAS the future for standardized measure of disease activity for lupus patients?

Comment on: Jesus D, Matos A, Henriques C, Zen M, Larosa M, Iaccarino L, Da Silva JAP, Doria A, Inês LS. Derivation and validation of the SLE Disease Activity Score (SLE-DAS): a new SLE continuous measure with high sensitivity for changes in disease activity. Ann Rheum Dis 2019;78(3):365-371.
Commented by: Iñigo Rúa-Figueroa. Rheumatologist. Principal investigator of RELESSER (Spanish Society of Rheumatology Lupus Register), Spain.

The objective and standardized estimation of disease activity has always been a necessity and, at the same time, a challenge in the management of such a heterogeneous and complex disease as systemic lupus erythematosus (SLE).

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Lupus quality of care: Unmet needs for bridging the gaps across multiple healthcare settings.

Comment on: Aggarwal I, Li J, Trupin L, Gaynon L, Katz PP, Lanata C, Criswell L, Murphy LB, Dall'Era M, Yazdany J. Quality of Care for the Screening, Diagnosis, and Management of Lupus Nephritis Across Multiple Healthcare Settings. Arthritis Care Res (Hoboken) 2019 May 6. doi: 10.1002/acr.23915. [Epub ahead of print] Link: https://onlinelibrary.wiley.com/doi/abs/10.1002/acr.23915
Commented by: Luís Inês, MD, PhD. Rheumatologist, CHUC Lupus Clinic, Rheumatology Dpt., Centro Hospitalar Universitário de Coimbra, Portugal. SLEuro general secretary.

In this study, Aggarval et al aimed to investigate if there are gaps in quality of care for patients with lupus nephritis (LN) across multiple healthcare settings (academic and community rheumatology practices) in the USA.

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Improving mortality of SLE patients: How far did we progress?

Comment on: Tselios K, Gladman DD, Sheane BJ, Su J, Urowitz M. All-cause, cause-specific and age-specific standardised mortality ratios of patients with systemic lupus erythematosus in Ontario, Canada over 43 years (1971-2013). Annals of the Rheumatic Diseases 2019; 78 (6): 802-806. Link: https://ard.bmj.com/content/78/6/802.long
Commented by: Luís Inês, MD, PhD. Rheumatologist, CHUC Lupus Clinic, Rheumatology Dpt., Centro Hospitalar Universitário de Coimbra, Portugal. SLEuro general secretary.

Survival of patients with systemic lupus erythematosus (SLE) has progressively improved over the last 50 years. The 5-year survival rate was estimated at 50% in 1955, while it reached 95% over the last decade in developed countries.

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