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Ismail AMA, Saad AE, Abd-Elrahman NAF, Elfahl AMA. Response of Lipid Profile to Laser Acupuncture along with Diet and Pilates Exercise in Obese Women with Systemic Lupus Erythematosus: a Randomized Controlled Trial. J Acupunct Meridian Stud 2023; 16:152-158. [PMID: 37609770 DOI: 10.51507/j.jams.2023.16.4.152] [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: 12/09/2022] [Revised: 03/08/2023] [Accepted: 07/27/2023] [Indexed: 08/24/2023] Open
Abstract
Background Obesity-induced dyslipidemia is one of the main factors contributing to morbidity and mortality associated with metabolic syndrome, atherosclerosis, and coronary artery disease among patients with systemic lupus erythematosus (SLE). Objectives This research aimed to assess the effect of adding laser acupuncture therapy (LAT) to a Pilates exercise program (PEP) and low-calorie diet protocol (LCDP) on blood lipids among 60 obese women with SLE. Methods Study participants were women aged between 23 and 49 years, randomly assigned to one of two groups, A or B, each comprising 30 women. In addition to adherence to the LCDP, both groups were supervised five times weekly during 50-minute PEP sessions. Group A also received LAT three times weekly, with each session lasting 2 minutes on selected acupoints. After the 12-week intervention, plasma total cholesterol, high-density lipoprotein, triglycerides, and low-density lipoprotein were assessed. Results Both groups demonstrated significant improvement in the aforementioned lipids after the 12-week intervention. A comparison between the post-intervention values of the lipids in the groups revealed a significant improvement favoring group A (the group that received LAT). Conclusion Adding a 12-week LAT regimen to PEP and LCDP significantly improved lipid profiles among 60 obese women with SLE.
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Affiliation(s)
- Ali Mohamed Ali Ismail
- Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Ahmad Elsayed Saad
- Department of Medical Biochemistry and Molecular Biology, Kasr Alainy Faculty of Medicine, Cairo University, Giza, Egypt
| | - Noha Ahmed Fouad Abd-Elrahman
- Department of Physical Therapy for Women's Health, Faculty of Physical Therapy, Badr University in Cairo, Cairo, Egypt
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Lu MC, Lo HC, Chang HH, Hsu CW, Koo M. Factors associated with the use of complementary therapies in Taiwanese patients with systemic lupus erythematosus: a cross-sectional study. BMC Complement Med Ther 2021; 21:247. [PMID: 34598699 PMCID: PMC8485480 DOI: 10.1186/s12906-021-03416-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 09/20/2021] [Indexed: 12/19/2022] Open
Abstract
Background This study aimed to investigate the prevalence of and the factors associated with the regular use of complementary therapies for Taiwanese patients with systemic lupus erythematosus (SLE). Methods In this cross-sectional study, 351 patients with SLE were consecutively recruited from a regional hospital in southern Taiwan from April to August 2019. Demographic and clinical information, including the use of different types of complementary therapies, was ascertained using a self-constructed questionnaire. Disease-specific quality of life was measured using the Lupus Quality of Life (LupusQoL) questionnaire. SLE disease activity was assessed using the rheumatologist-scored Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2 K). Factors associated with the regular use of complementary therapies were evaluated using multiple logistic regression analyses. Results Of the 351 patients with SLE, 90.3% were female, and 60.1% were ≥ 40 years of age. The prevalence of the regular use of any type of complementary therapy was 85.5%. The five most popular types of complementary therapy used were (1) fitness walking or strolling, (2) Buddhist prayer or attending temple, (3) vitamin consumption, (4) calcium supplementation, and (5) fish oil supplementation. Multiple logistic regression analyses revealed that the significant and independent factors associated with the regular use of complementary therapies in patients with SLE were age ≥ 40 years (adjusted odds ratio [aOR] 2.76, p = 0.013), nonoverweight or nonobesity (aOR 0.29, p = 0.004), engagement in vigorous exercise in the past year (aOR 4.62, p = 0.002), a lower SLEDAI-2 K score (aOR 0.90, p = 0.029), and a lower score in the physical health domain of the LupusQoL (aOR 0.57, p = 0.001). Conclusions A high prevalence of complementary therapy use in Taiwanese patients with SLE was observed. Rheumatologists should routinely ask patients about their use of supplements to minimize the risk of interaction with medical therapy. Supplementary Information The online version contains supplementary material available at 10.1186/s12906-021-03416-w.
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Affiliation(s)
- Ming-Chi Lu
- Division of Allergy, Immunology and Rheumatology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan.,School of Medicine, Tzu Chi University, Hualien City, Taiwan
| | - Hui-Chin Lo
- Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan
| | - Hsiu-Hua Chang
- Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan
| | - Chia-Wen Hsu
- Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan
| | - Malcolm Koo
- Graduate Institute of Long-term Care, Tzu Chi University of Science and Technology, Hualien City, Hualien, 970302, Taiwan. .,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
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Wang Y, Han M, Pedigo CE, Xie ZM, Wang WJ, Liu JP. Chinese Herbal Medicine for Systemic Lupus Erythematosus: A Systematic Review and Meta-analysis of Randomized, Placebo-Controlled Trials. Chin J Integr Med 2021; 27:778-787. [PMID: 34319503 DOI: 10.1007/s11655-021-3497-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To provide evidence on the efficacy and safety of Chinese herbal medicine (CHM) as interventions for systemic lupus erythematosus (SLE). METHODS Seven electronic databases, including the Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), Chinese Biomedical Literature Service System (SinoMed), Wanfang, Embase, and PubMed, were comprehensively searched, from their inception to August 16, 2020, for all randomized controlled trials (RCTs) that focused on CHM used alone or in combination with conventional medicine for SLE. Outcomes were SLE activity index (SLEDAI), traditional Chinese medicine symptom/syndrome score (TCMSS), dosage of glucocorticoids, main serological testing, and incidence of adverse events. Data were extracted and pooled using Review Manager 5.3 software. RESULTS A total of 13 RCTs enrolling 856 participants met our inclusion criteria. Meta-analyses showed that, compared to placebo, CHM had statistically significant effect on reducing SLEDAI score (MD=-1.74, 95% CI: -2.29 to -1.18), diminishing TCMSS (SMD=-0.89, 95% CI: -1.16 to -0.62), decreasing dosage of glucocorticoids (MD=-2.41 mg/d, 95% CI: -3.34 to -1.48), lowering erythrocyte sedimentation rate (MD=-4.78 mm/h, 95% CI: -8.86 to -0.71), and increasing serum complement C4 level (MD=0.03 mg/dL, 95% CI: 0.00 to 0.06). No significant difference was found between CHM and placebo on adverse events. CONCLUSIONS CHM provided significant beneficial effect on controlling disease activity and reducing dose of glucocorticoids used among SLE patients. Future advanced designed RCTs for CHM treating moderate to severe SLE with multicenter and longer follow-up are urgently needed.
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Affiliation(s)
- Ying Wang
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China
- Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, 06520, USA
| | - Mei Han
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Christopher E Pedigo
- Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, 06520, USA
| | - Zhi-Min Xie
- Department of Rheumatology, the Second Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine, Hangzhou, 310005, China
| | - Wei-Jie Wang
- Department of Rheumatology, the Second Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine, Hangzhou, 310005, China
| | - Jian-Ping Liu
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China.
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Corneloup M, Maurier F, Wahl D, Muller G, Aumaitre O, Seve P, Blaison G, Pennaforte JL, Martin T, Magy-Bertrand N, Berthier S, Arnaud L, Bourredjem A, Amoura Z, Devilliers H. Disease-specific quality of life following a flare in systemic lupus erythematosus: an item response theory analysis of the French EQUAL cohort. Rheumatology (Oxford) 2020; 59:1398-1406. [PMID: 31620787 DOI: 10.1093/rheumatology/kez451] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 07/30/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To explore, at an item-level, the effect of disease activity (DA) on specific health-related quality of life (HRQoL) in SLE patients using an item response theory longitudinal model. METHODS This prospective longitudinal multicentre French cohort EQUAL followed SLE patients over 2 years. Specific HRQoL according to LupusQoL and SLEQOL was collected every 3 months. DA according to SELENA-SLEDAI flare index (SFI) and revised SELENA-SLEDAI flare index (SFI-R) was evaluated every 6 months. Regarding DA according to SFI and each SFI-R type of flare, specific HRQoL of remitting patients was compared with non-flaring patients fitting a linear logistic model with relaxed assumptions for each domain of the questionnaires. RESULTS Between December 2011 and July 2015, 336 patients were included (89.9% female). LupusQoL and SLEQOL items related to physical HRQoL (physical health, physical functioning, pain) were most affected by musculoskeletal and cutaneous flares. Cutaneous flares had significant influence on self-image. Neurological or psychiatric flares had a more severe impact on specific HRQoL. Patient HRQoL was impacted up to 18 months after a flare. CONCLUSION Item response theory analysis is able to pinpoint items that are influenced by a given patient group in terms of a latent trait change. Item-level analysis provides a new way of interpreting HRQoL variation in SLE patients, permitting a better understanding of DA impact on HRQoL. This kind of analysis could be easily implemented for the comparison of groups in a clinical trial. TRIAL REGISTRATION ClinicalTrials.gov, http://clinicaltrials.gov, NCT01904812.
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Affiliation(s)
- Marie Corneloup
- Clinical Investigation Center, INSERM CIC-EC 1432, University Hospital Dijon-Burgundy, Dijon
| | - François Maurier
- Department of Internal Medicine and Clinical Immunology, Site Belle Isle, Metz
| | - Denis Wahl
- Vascular Medicine Division and Regional Competence Center for Rare Vascular and Systemic Autoimmune Diseases, CHRU de Nancy.,Inserm UMR_S 1116 at Lorraine University, Nancy
| | - Geraldine Muller
- Internal Medicine and Systemic Diseases Unit, University Hospital Centre Dijon, Dijon
| | - Olivier Aumaitre
- Department of Internal Medicine, Centre Hospitalier Universitaire, Hôpital Gabriel Montpied, Clermont-Ferrand
| | - Pascal Seve
- Department of Internal Medicine, University Hospital, Hôpital Croix Rousse, Lyon
| | - Gilles Blaison
- Department of Internal Medicine, Hopital Louis Pasteur, Colmar, Alsace
| | | | - Thierry Martin
- Internal Medicine and Clinical Immunology Department, Strasbourg University Hospital, Strasbourg
| | | | - Sabine Berthier
- Internal Medicine and Clinical Immunology Unit, University Hospital Dijon-Burgundy, Dijon
| | - Laurent Arnaud
- Department of Rheumatology, Hôpitaux Universitaires de Strasbourg.,INSERM UMR-S 1109, Strasbourg
| | - Abderrahmane Bourredjem
- Clinical Investigation Center, INSERM CIC-EC 1432, University Hospital Dijon-Burgundy, Dijon
| | - Zahir Amoura
- Department of Internal Medicine, National Referral Center for Systemic Lupus Erythematosus and Anti-Phospholipid Syndrome, Pitie-Salpetriere University Hospital, Paris, France
| | - Hervé Devilliers
- Clinical Investigation Center, INSERM CIC-EC 1432, University Hospital Dijon-Burgundy, Dijon
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Balkrishna A, Thakur P, Singh S, Chandra Dev SN, Varshney A. Mechanistic Paradigms of Natural Plant Metabolites as Remedial Candidates for Systemic Lupus Erythromatosus. Cells 2020; 9:cells9041049. [PMID: 32331431 PMCID: PMC7226400 DOI: 10.3390/cells9041049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 04/13/2020] [Accepted: 04/14/2020] [Indexed: 12/20/2022] Open
Abstract
Systemic lupus erythematosus (SLE) is a complex autoimmune disorder involving a dysregulated immune response which ultimately leads to multiple organ failure. Several immunological and cellular checkpoints are available as drug targets. However, the available chemosynthetic drugs such as non-steroidal anti-inflammatory drugs and corticosteroids provide limited therapy with extreme toxicities. Moreover, the disease heterogeneity in SLE is very difficult to manage by a single drug component. Hence, it is imperative to utilize the holistic capabilities of natural plant products as immunomodulators and intracellular signaling regulators, thereby providing an auxiliary option of treatment. Additionally, the herbal drugs also serve as symptomatic relief providers, thereby serving as a prophylactic remedy in case of cerebrovascular, hepatic, nephropathological, hematological, cardiopulmonary, mucocutaneous and musculoskeletal manifestations of SLE. The present review attempts to showcase the current state of knowledge regarding the utility of plant-derived phyto-metabolites with their probable mechanistic roles in treating SLE, by means of targeting the signaling cascade, proinflammatory cytokine production and B–T cell co-stimulation. It is hoped that further preclinical and clinical studies will be embarked upon in order to understand the underlying therapeutic and mechanistic aspects of these medicinal herbs.
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Affiliation(s)
- Acharya Balkrishna
- Drug Discovery and Development Division, Patanjali Research Institute, NH-58, Haridwar, Uttarakhand 249 405, India
- Department of Allied and Applied Sciences, University of Patanjali, Patanjali Yog Peeth, Roorkee-Haridwar Road, Haridwar, Uttarakhand 249 405, India
| | - Pallavi Thakur
- Drug Discovery and Development Division, Patanjali Research Institute, NH-58, Haridwar, Uttarakhand 249 405, India
| | - Shivam Singh
- Drug Discovery and Development Division, Patanjali Research Institute, NH-58, Haridwar, Uttarakhand 249 405, India
| | - Swami Narsingh Chandra Dev
- Drug Discovery and Development Division, Patanjali Research Institute, NH-58, Haridwar, Uttarakhand 249 405, India
| | - Anurag Varshney
- Drug Discovery and Development Division, Patanjali Research Institute, NH-58, Haridwar, Uttarakhand 249 405, India
- Department of Allied and Applied Sciences, University of Patanjali, Patanjali Yog Peeth, Roorkee-Haridwar Road, Haridwar, Uttarakhand 249 405, India
- Correspondence: ; Tel.: +91-1334-240008
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6
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Elera-Fitzcarrald C, Fuentes A, González LA, Burgos PI, Alarcón GS, Ugarte-Gil MF. Factors affecting quality of life in patients with systemic lupus erythematosus: important considerations and potential interventions. Expert Rev Clin Immunol 2018; 14:915-931. [DOI: 10.1080/1744666x.2018.1529566] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Claudia Elera-Fitzcarrald
- Rheumatology Department, Hospital Guillermo Almenara Irigoyen, EsSalud, Lima, Perú
- Universidad Científica del Sur, Lima, Perú
| | - Alejandro Fuentes
- Departamento de Inmunología Clínica y Reumatología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Luis Alonso González
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - Paula I. Burgos
- Departamento de Inmunología Clínica y Reumatología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Graciela S. Alarcón
- The University of Alabama at Birmingham, Birmingham, AL, USA
- Division of Clinical Immunology and Rheumatology, Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Manuel F. Ugarte-Gil
- Rheumatology Department, Hospital Guillermo Almenara Irigoyen, EsSalud, Lima, Perú
- Universidad Científica del Sur, Lima, Perú
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7
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Devilliers H, Vernier N, Muller G, Turcu A, Samson M, Bielefeld P, Besancenot JF. [Quality of life measures in SLE: An update]. Rev Med Interne 2017; 39:107-116. [PMID: 28457682 DOI: 10.1016/j.revmed.2017.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 02/28/2017] [Accepted: 03/04/2017] [Indexed: 12/20/2022]
Abstract
Systemic lupus erythematosus (SLE) is a chronic disease that considerably hampers patient's daily living. Qualitative studies with patients' interviews have been conducted to describe the experiences and perspectives of adults living with SLE. Among existing generic and disease-specific quality of life (QOL) questionnaires, none succeeded to exhaustively measure patient's preoccupations. However, these tools are useful to quantify the burden of the disease. Social precariousness, socioeconomic status and education level are intimately correlated to QOL measures, either generic or disease-specific. Musculoskeletal disease activity is also associated with a lower QOL. Using disease-specific tools may be useful because of a better aptitude to record an improvement in health status. Moreover, using generic and disease-specific questionnaires together may help to identify factors associated with a lower quality of life but not related to SLE from the patient's perspective (such as smoking or obesity). Developing new ways of recording QOL data in the future may help to evaluate the real benefit of using QOL scales in daily practice.
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Affiliation(s)
- H Devilliers
- Service de médecine interne et maladies systémiques (médecine interne 2), hôpital François-Mitterrand, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France.
| | - N Vernier
- Service de médecine interne et maladies systémiques (médecine interne 2), hôpital François-Mitterrand, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France
| | - G Muller
- Service de médecine interne et maladies systémiques (médecine interne 2), hôpital François-Mitterrand, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France
| | - A Turcu
- Service de médecine interne et maladies systémiques (médecine interne 2), hôpital François-Mitterrand, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France
| | - M Samson
- Service de médecine interne et immunologie clinique (médecine interne 1), hôpital François-Mitterrand, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon, France
| | - P Bielefeld
- Service de médecine interne et maladies systémiques (médecine interne 2), hôpital François-Mitterrand, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France
| | - J-F Besancenot
- Service de médecine interne et maladies systémiques (médecine interne 2), hôpital François-Mitterrand, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France
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8
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Liu CY, Wu WH, Huang TP, Lee TY, Chang HH. A novel model for exploring the correlation between patterns and prescriptions in clinical practice of traditional Chinese medicine for systemic lupus erythematosus. Complement Ther Med 2014; 22:481-8. [DOI: 10.1016/j.ctim.2014.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Revised: 03/07/2014] [Accepted: 03/17/2014] [Indexed: 12/24/2022] Open
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Greco CM, Nakajima C, Manzi S. Updated review of complementary and alternative medicine treatments for systemic lupus erythematosus. Curr Rheumatol Rep 2013; 15:378. [PMID: 24078104 PMCID: PMC3898893 DOI: 10.1007/s11926-013-0378-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
It is estimated that over 50 % of patients with systemic lupus erythematosus (SLE) have utilized complementary and alternative medicine (CAM) treatments to reduce symptoms and manage their health. However, there are relatively few randomized controlled trials of CAM for SLE. This review describes recent studies of vitamins and supplements, acupuncture, and mind-body interventions in SLE patients. The recent trials of CAM treatments for SLE indicate that supplements such as vitamin D, omega 3 fatty acids, N-acetyl cysteine and turmeric show some promise for reducing SLE disease activity. In addition, mind-body methods such as cognitive-behavioral therapy and other counseling interventions may improve mood and quality of life in SLE.
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Affiliation(s)
- Carol M. Greco
- Assistant Professor of Psychiatry, University of Pittsburgh School of Medicine, UPMC Shadyside Center for Integrative Medicine, 580 South Aiken Avenue, Suite 310, Pittsburgh, PA 15232, USA, Phone: 412-623-3023, Fax: 412-623-6414
| | - Claire Nakajima
- Graduate Program in Psychology, Teachers College, Columbia University, 525 W 120 Street, New York, NY 10027, USA, Phone: 267-334-3335
| | - Susan Manzi
- Chair, Department of Medicine, Allegheny Health Network, Vice Chair and Professor of Medicine, Temple University School of Medicine, Address: Department of Medicine, 2 Floor, 320 East North Avenue, Pittsburgh, PA 15212, USA, Phone: 412-359-3022, Fax: 412-359-8152
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Haija AJ, Schulz SW. The role and effect of complementary and alternative medicine in systemic lupus erythematosus. Rheum Dis Clin North Am 2010; 37:47-62. [PMID: 21220085 DOI: 10.1016/j.rdc.2010.11.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The use of complementary and alternative medicine (CAM) is common among patients with systemic lupus erythematosus (SLE), especially those with active disease who often have poorer quality of life and significant unmet needs. It is important for the rheumatologist to be aware of these therapies and to ask the patient with SLE about their active use or future interest in CAM. Future studies on the effectiveness of the aforementioned therapies will be crucial to find better ways for the rheumatologist to integrate their use into the care of the patient with SLE.
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Affiliation(s)
- Anan J Haija
- Division of Rheumatology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
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Abstract
Systemic lupus erythematosus (SLE) is an autoimmune disease with higher morbidity and mortality among ethnic Chinese patients than Whites. Corticosteroid and other immunosuppressive drugs, including cyclophosphamide, azathioprine, and hydroxychloroquine are traditional therapies for this disease. Since the year 2000, mycophenolate mofetil and rituximab have been widely used in refractory SLE or severe lupus nephritis. Because the high disease activity remains, even after active therapy, and serious side effects from Western medicines may develop, more than 40% of SLE patients in Western countries are pursuing complementary and alternative therapies (CATs). CAT remedies are multiplex, and include herbal medicines, diets and vitamins, acupuncture, chiropractice, folk medicine, massage, spiritual healing, etc. Many herbal formulas have been used but in general their efficacy in treating lupus is doubted because of the lack of strong evidence. Tripterygium (T2) has demonstrated good efficacy in rheumatoid arthritis (RA) and SLE, but widespread use is limited due to the side effects. Through randomized clinical trials, we hope in the future that some Chinese medicines may be found helpful as CATs for SLE.
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Affiliation(s)
- C-T. Chou
- Division of Allergy-Immunology-Rheumatology, Department of Medicine, Veterans General Hospital, Taipei, Taiwan,
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