was observed. In addition, a significant increase in muscle strength and a reduction in body fat could be demonstrated. Conclusion Due to the initial significantly reduced cardiorespiratory fitness of the patients, but with promising first data showing a benefit of the patients after the training program, a follow-up study with a larger SLE patient collective over a period of 2 years is planned. In addition, a murine comparative study will be initiated in the spontaneous lupus mouse model of the MRL-Fas lpr mice. On the one hand, the influence of physical exercise on disease activity and progression of SLE should be analysed. Furthermore, we want to investigate the effects of physical activity on the musculature (inflammation, necrosis and fibrosis) and cardiovascular damage.
activity of BLyS, effectively and safely treats SLE, but data on treatment cessation are lacking. Therefore, we investigated belimumab-free remission in SLE patients. Methods SLE patients receiving belimumab in our institute (1/ 1/2013-5/31/2019) were retrospectively identified using electronic health records. Eligibility criteria were receiving belimumab for >180 days and discontinuation for any reason. BILAG category A or B in at least one organ system defined disease flares. Follow-up monitoring after 52 weeks post-treatment identified relapse-free and relapse patients. Results 31 patients received belimumab. While 14 patients discontinued, eight were included. Four patients relapsed within 52 weeks. Relapse-free patients received significantly less steroid at discontinuation (prednisolone equivalent, median 3.0 mg/day [IQR 2.75-3.19] vs. 9.5 mg/day [IQR 7.25-13.25], p=0.02), and significantly more of them achieved PSL dosage of <5 mg/day on discontinuation day than relapse patients. (p=0.03) At belimumab discontinuation, relapse-free patients tended to have higher C3 (median 91.0 mg/dL [IQR 78.75-102.25] vs. 56.0 mg/dL [IQR 39.75-73.00], p=0.15) and C4 levels (median 22.0 mg/dL [IQR 19.00-26.00] vs. 11.0 mg/dL [IQR 6.00-16.00], p=0.08) and less anti-DNA antibody (median 5.2 IU/mL [IQR 3.75-7.83] vs. 48.0 IU/mL [IQR 11.50-137.25I], p=0.08) than relapse patients, but differences were not significant. Conclusion Belimumab discontinuation after >180 days is recommended for 50% of SLE patients. Steroid dosage (prednisolone equivalent <5 mg/day) might be a prognostic marker for belimumab-free remission.
Background Cardiovascular disease is the leading cause of mortality for patients with lupus. Understanding increased cardiovascular risk (CVR) in autoimmune diseases could improve CVR management in patients. The objective of a patient-focused event was to explore patient opinions about CVR and potential treatment options. A secondary objective was to learn about lupus patient experiences with diet including their opinion on considering diet as a therapeutic. Methods We hosted a patient event promoted through social media, relevant charities, hospitals and research groups. 13 patients with lupus and/or Sjögren’s syndrome attended and were asked about CVR using a questionnaire and round table discussion with researchers, clinicians and dietitians. In addition, a 15-question diet-based online survey was made publicly available for 3 weeks promoted through the same methods as the patient event. Results Sixty percent of patients were aware of the increased CVR associated with autoimmune rheumatic disease and 60% stated that their doctor had spoken to them about CVR. 73% thought that it was important for them to be aware of this increased CVR. When asked about medication to reduce CVR; no patients wanted to take a statin (lipid-lowering drug), however, 70% of patients would take statins if advised by their doctor. Conversely, respondents were more positive about using diet or taking a dietary supplement to reduce CVR; 71% would change their diet and 57% would take a supplement either on their own accord or on advice from health professionals. Some patients had already made changes to their diet to reduce their CVR, including reducing fat and increasing fruit and vegetable consumption. All attendees were prepared to participate in a clinical study using diet modification strategies, having vascular scans to assess atherosclerosis and provide blood samples for CVR research in lupus. An online survey was used to further assess lupus patient opinion on modifying their diet depending on their CVR. 284 responses were received over 3 weeks. Patients reported there was a lack of clinical counselling regarding diet with only 24% of patients stating that their doctor had spoken to them about diet. Despite this, 100% of patients stated that they would change their diet if they knew it would help their symptoms and 83% would take part in a diet-based clinical trial, supporting the results from the face-to-face patient event. Text analysis of patient research suggestions identified an interest in using diet to manage fatigue and disease activity. Conclusion This multidisciplinary event and online survey successfully gathered patient information regarding CVR and diet. The opinions and comments provided evidence that patients support further research in cardiovascular studies, a demand for increased CVR and dietary clinical counselling and a preference to changing their diet, whilst avoiding medication, to reduce their CVR. Disclosures G.A. Robinson None. E. Chocano Navarro None. K. Waddington None. T. Mcdonnell None. C. Wincup None. L. Martin-Gutierrez None. A. Maggio None. E. McLoughlin None. L. Rosser None. M. Naja None. D.A. Isenberg None. A.Z. Kalea None. C. Ciurtin None. I. Pineda-Torra None. E.C. Jury None.
Background and aims Prolactin has been found to be associated with immune regulation in SLE. The aim of this study is to determine the correlation between high prolactin level in comparison with IL -6 with lupus nephritis disease activity in UKMMC. Methods In this cross-sectional study, the analysis was conducted in SLE patients who attended Nephrology clinic in UKMMC from August 2015 till February 2016 Results Out of 43 patients with lupus nephritis, 27.9% of the patients had raised serum prolactin. The median of serum prolactin level at 0 min was 19.91 ng/ml (IQR: 15.95-22.65 ) for active lupus nephritis that was significantly higher as compared to the median of serum prolactin level 14.34 ng/ml (IQR: 11.09-18.70 ) for patients in remission (p=0.014). The serum prolactin level was positively correlated to SLEDAI (rho s : 0.449, p=0.003 ) and UPCI level in lupus nephritis patients (rho s : 0.241, p=0.032). Assessment of serum IL-6 levels found that the active lupus nephritis patients were having a higher median level of 65.91 pg/ml (21.96-146.14) compared to in remission level of 15.84 pg/ml (IQR: 8.38-92.84), (p=0.039). ROC curve analysis of serum prolactin 0 min and serum prolactin 30 min and IL-6 level for prediction of SLE diseases activity provide the cutoff value of serum prolactin 0 min was 14.63 ng/ml with sensitivity 91.7% and specificity 58.1% and AUC of 0.74 (p=0.015). Conclusions Baseline fasting serum prolactin level was found to be a sensitive biomarker for evaluation of lupus nephritis disease activity. Background and aims Plasmacytoid dendritic cells (pDC) are potent producers of IFNa, we investigated what additional soluble factors are produced by pDCs and the effect of pDC depletion with JNJ-56022473 (JNJ-473), a novel antibody against CD123. We then investigated which of these factors are elevated in SLE patient sera to determine potential biomarkers. Methods pDCs were isolated from healthy donor (HD) PBMC (n=6) which were stimulated with CpGc (TLR9) and imiquimod (TLR7) then analysed by RNAseq. PBMC from SLE and HD were also treated with isotype or JNJ-473 before stimulation with CpGc for 24 hour. Culture supernatant, SLE (n=33) and HD sera (n=34) was analysed by bead-based multiplex assay (Myriad U.S.A).Results TLR9 and TLR7-agonism induced the regulation of thousands of genes, many of which were different IFNa-subtypes. Transcripts of many other secreted proteins such as MCP-2/CCL8, IP-10/CXCL10, ITAC/CXCL11 and MIP-3b/ CCL19 were also upregulated. Proteins of these were also found to be significantly increased in SLE sera compared to HD.Depleting pDCs with JNJ-473 in SLE and HD PBMC cultures reduced production of many CpGc-induced proteins including IFNa, MCP-2/CCL8, IP-10/CXCL10, ITAC/CXCL11 and MIP-3b/CCL19. RNAseq of SLE PBMC treated with JNJ-473 before CpGc stimulation, confirmed significantly decreased expression of MCP-2/CCL8, IP-10/CXCL10 and ITAC/CXCL11. Conclusions We found that pDC depletion with JNJ-473 was able to prevent TLR9-induced production of IFNa and various other solub...
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