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González-García A, Cusácovich I, Ruiz-Irastorza G. Treatment of systemic lupus erythematosus: new therapeutic options. Rev Clin Esp 2023; 223:629-639. [PMID: 38000622 DOI: 10.1016/j.rceng.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/01/2023] [Indexed: 11/26/2023]
Abstract
Systemic lupus erythematosus (SLE) is a systemic autoimmune inflammatory disease of unknown cause, with heterogeneity in its clinical presentation, as well as variability in its clinical course and prognosis. The current goal of treatment is to achieve disease remission or a state of low activity, and thereby improve the patient's quality of life. Biological therapy in lupus, unlike other entities, although it has not been fully established, in recent years it has burst onto the scene with important therapeutic novelties. This review aims to update the therapeutic tools for the treatment of SLE focusing on the new molecules that have achieved the objectives of their clinical trials.
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Affiliation(s)
- A González-García
- Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain.
| | - I Cusácovich
- Servicio de Medicina Interna, Hospital Clínico Universitario, Valladolid, Spain
| | - G Ruiz-Irastorza
- Unidad de Enfermedades Autoinmunes, Servicio de Medicina Interna, BioCruces Bizkaia Health Research Institute, Hospital Universitario Cruces, UPV/EHU, Barakaldo, Bizkaia, Spain
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Sebastiani GD, Spinelli FR, Bartoloni E, Bortoluzzi A, Bozzolo E, Canofari C, Canti V, Conigliaro P, Ditto MC, Emmi G, Franceschini F, Frassi M, Iaccarino L, Iuliano A, Manfredi A, Pacucci V, Parisi S, Pazzola G, Perricone R, Prevete I, Ramirez GA, Scarpato S, Scirocco C, Silvagni E, Zen M, Zanetti A, Carrara G, Scirè CA, Conti F, Doria A. Baseline characteristics of systemic lupus erythematosus patients included in the Lupus Italian Registry of the Italian Society for Rheumatology. Lupus 2021; 30:1233-1243. [PMID: 33884900 DOI: 10.1177/09612033211012470] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To report baseline data of SLE patients enrolled in the Lupus Italian Registry (LIRE). METHODS Patients affected by SLE aged ≥ 16 years were consecutively recruited in a multicenter prospective study comparing two cohorts: patients starting biologic immunosuppressants (BC) and patients starting non-biologic immunosuppresants (NBC). RESULTS 308 patients were enrolled, 179 in NBC and 129 in BC. Mean age at disease onset and at diagnosis was significantly higher in NBC (p = 0.023, p = 0.045, respectively). Disease duration was longer in BC (p = 0.022). Patients in BC presented arthritis more frequently (p = 0.024), those in NBC nephropathy (p = 0.03). Quality of life was worse in BC (p = 0.031). Anti-dsDNA, low C3, were significantly more frequent in BC (p < 0.001, p = 0.009, respectively). Mycophenolate, methotrexate and azathioprine were the drugs more frequently prescribed in NBC, Belimumab and Rituximab in BC. CONCLUSION The predominant organ involvement was different in the two cohorts: kidney involvement predominated in NBC, joint involvement in BC. Despite the younger age at disease onset, patients of the BC had a longer disease duration and more frequently had taken a cumulative prednisone dosage greater than 10 g. Even the pattern of clinical manifestations inducing to prescribe biological rather than conventional immunosuppressants was quite different.Keywords: Autoantibody(ies), autoimmune disease, belimumab, cohort studies, glucocorticoids, immunosuppressants, rituximab, systemic lupus erythematosus.
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Affiliation(s)
| | | | | | | | - Enrica Bozzolo
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Claudia Canofari
- Rheumatology Unit, San Camillo - Forlanini Hospital, Rome, Italy
| | - Valentina Canti
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Paola Conigliaro
- Rheumatology, Allergology and Clinical Immunology, Department of "Medicina dei Sistemi", University of Rome "Tor Vergata", Rome, Italy
| | - Maria Chiara Ditto
- Rheumatology Unit, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Giacomo Emmi
- Dipartimento di Medicina Clinica e Sperimentale, University of Firenze, Firenze, Italy
| | - Franco Franceschini
- Dipartimento di Scienze Cliniche e Sperimentali, Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili, University of Brescia, Brescia, Italy
| | - Micol Frassi
- Dipartimento di Scienze Cliniche e Sperimentali, Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili, University of Brescia, Brescia, Italy
| | | | | | - Angelo Manfredi
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Viviana Pacucci
- Rheumatology Unit, "Sapienza" University of Rome, Rome, Italy
| | - Simone Parisi
- Rheumatology Unit, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Giulia Pazzola
- Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Roberto Perricone
- Rheumatology, Allergology and Clinical Immunology, Department of "Medicina dei Sistemi", University of Rome "Tor Vergata", Rome, Italy
| | | | - Giuseppe Alvise Ramirez
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, Milan, Italy
| | | | - Chiara Scirocco
- Rheumatology Unit, San Camillo - Forlanini Hospital, Rome, Italy
| | - Ettore Silvagni
- Rheumatology Unit, University of Ferrara e AOU S. Anna, Ferrara, Italy
| | | | - Anna Zanetti
- Epidemiology Unit, Italian Society of Rheumatology, Milan, Italy.,Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, University of Milano-Bicocca, Milan, Italy
| | - Greta Carrara
- Epidemiology Unit, Italian Society of Rheumatology, Milan, Italy
| | - Carlo Alberto Scirè
- Rheumatology Unit, University of Ferrara e AOU S. Anna, Ferrara, Italy.,Epidemiology Unit, Italian Society of Rheumatology, Milan, Italy
| | - Fabrizio Conti
- Rheumatology Unit, "Sapienza" University of Rome, Rome, Italy
| | - Andrea Doria
- Rheumatology Unit, University of Padova, Padova, Italy
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