SLEuro Today

SLEuro Today

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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