Alcohol, smoking and illicit drug use in pediatric systemic lupus erythematosus patients

Weelden, Marlon van; Queiroz, Lígia Bruni; Lourenço, Daniela Mencaroni Rodrigues; Kozu, Kátia; Lourenço, Benito; Silva, Clóvis A.

doi:10.1016/j.rbre.2016.02.001

Cited by 10 publications

(8 citation statements)

References 21 publications

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“…Furthermore, alcohol intake and illicit drug were also important issues evidenced in adolescents, particularly reported by LAPR in large centers. These results may be due to the easier access of these substances in LA [30], despite the public health policies in many of the countries.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and management practices for childhood-onset systemic lupus erythematosus patients: a survey in Latin America

et al. 2018

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To assess epidemiology and management practices of Latin America Pediatric Rheumatologists (LAPR) about childhood-onset systemic lupus erythematosus (cSLE). A cross-sectional study was performed in 288 LAPR PANLAR members based on online survey about cSLE practices. The response rate of web-based survey by LAPR was 170/288(59%) and the majority worked in university hospitals (63%). The ACR and/or SLICC classification criteria (99%) and disease activity tools (97%) were almost universally used by LAPR, whereas damage index (70%) and CHAQ (58%) instruments were less frequently used. Laboratory exams, diagnostic imaging, and biopsies were generally available (> 75%), however low availability for densitometry (66%). Drug access was excellent for the most common prescribed medications (> 75%), except for belimumab (11%). Emerging mosquito-borne diseases were also reported: dengue (20%), chikungunya (11%), and Zika (8%). Groups were further divided in two, according to the median number of cSLE patients followed by LAPR in the last year: groups A and B (≥ 25 and < 25, respectively). Frequencies of condom in combination with other contraceptive methods were significantly higher in group A than B (p = 0.01). The frequencies of reported pregnancy (p < 0.001) and non-adherence to therapy were significantly higher in group A (p = 0.023). Alcohol intake (p = 0.004) and illicit drug use (p = 0.007) were also reported more frequently by LAPR of group A in at least one cSLE patient. This first large web-based survey demonstrated an overall excellent access for diagnosis and therapy by LAPR, probably related to their high rate of practices in tertiary care of university hospitals. Adherence to therapy, pregnancy, and substance abuse was identified as major challenges in this population, particularly in larger centers.

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Section: Discussionmentioning

confidence: 99%

Epidemiology and management practices for childhood-onset systemic lupus erythematosus patients: a survey in Latin America

et al. 2018

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“…Age of first sexual activity occurred mainly in late adolescence for our JIA patients and controls. However, other studies reported an earlier age of first sexual intercourse at 15 years in female JIA [4] and at 15 years in female childhood-onset systemic lupus erythematosus patients [14,15].…”

Section: Discussionmentioning

confidence: 81%

“…The median of DAS28 was 2 (1.05-4.14) and 38% of JIA patients has DAS28 > 2.3. (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) vs. 17 (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) years, p = 0.158] were similar in JIA patients and healthy controls. No differences were evidenced in frequencies of dysmenorrhea (62% vs. 60%, p = 0.859), menorrhagia (24% vs. 20%, p = 1.000) and premenstrual syndromes (67% vs. 75%, p = 0.538) in both groups (Table 1).…”

Section: Resultsmentioning

confidence: 89%

Sexual function in female juvenile idiopathic arthritis patients

et al. 2019

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Objective: To evaluate sexual function female adolescents and young adults with juvenile idiopathic arthritis (JIA) and healthy controls. Methods: After exclusion, 21 female adolescent and young JIA patients and 25 healthy controls were selected for this study. Sexual function was assessed by the Sexual Quotient Questionnaire for Females (SQQ-F) score, which is a validated tool and adapted for Brazilian Portuguese language. Demographic data, JIA clinical/laboratory parameters and treatment were also assessed. Results: The median current age [26.5 (17-38.1) vs. 29.3 (19.7-35.8) years, p = 0.700)] as well as age at the first sexual activity [18 (14-30) vs. 17 (10-24) years, p = 0.158] were similar in JIA patients and healthy controls. The median of SQQ-F score was alike in both groups [75.9 (50-92) vs. 78.2 (58-94), p = 0.529], as well as frequencies of sexual dysfunction (14% vs. 12%, p = 1.000). The frequencies of all sexual domains (desire/sexual fantasies, desire/interest, arousal/foreplay, arousal/lubrication, arousal/in tune with partner, penetration/relaxation, pain/penetration, desire/involvement, orgasm and general satisfaction scores) were similar in JIA patients and healthy controls (p > 0.05). Conclusions: To our knowledge, this was the first study using a validated sexual score in a chronic arthritis population suggesting a low frequency of overall sexual dysfunction in young JIA patients. Future multicenter studies with a large sample will be necessary to confirm this finding.

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“…cSLE patients are mainly in the adolescence period [ 20 ]. This transitional phase to adulthood involves several physical and emotional changes [ 37 ], and the impact of this complex disease may affect their self-management and self-esteem [ 174 , 175 ]. In fact, a cSLE study in adolescents and young adults with a semi-structured interview showed that the use of medication served as reminders of their illness and made them feel abnormal [ 176 ].…”

Section: Drug Adherence For Adolescentsmentioning

confidence: 99%

An Update on the Management of Childhood-Onset Systemic Lupus Erythematosus

et al. 2021

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Childhood-onset systemic lupus erythematosus (cSLE) is a prototype of a multisystemic, inflammatory, heterogeneous autoimmune condition. This disease is characterized by simultaneous or sequential organ and system involvement, with unpredictable flare and high levels of morbidity and mortality. Racial/ethnic background, socioeconomic status, cost of medications, difficulty accessing health care, and poor adherence seem to impact lupus outcomes and treatment response. In this article, the management of cSLE patients is updated. Regarding pathogenesis, a number of potential targets for drugs have been studied. However, most treatments in pediatric patients are off-label drugs with recommendations based on inadequately powered studies, therapeutic consensus guidelines, or case series. Management practices for cSLE patients include evaluations of disease activity and cumulative damage scores, routine non-live vaccinations, physical activity, and addressing mental health issues. Antimalarials and glucocorticoids are still the most common drugs used to treat cSLE, and hydroxychloroquine is recommended for nearly all cSLE patients. Disease-modifying antirheumatic drugs (DMARDs) should be standardized for each patient, based on disease flare and cSLE severity. Mycophenolate mofetil or intravenous cyclophosphamide is suggested as induction therapy for lupus nephritis classes III and IV. Calcineurin inhibitors (cyclosporine, tacrolimus, voclosporin) appear to be another good option for cSLE patients with lupus nephritis. Regarding B-cell-targeting biologic agents, rituximab may be used for refractory lupus nephritis patients in combination with another DMARD, and belimumab was recently approved by the US Food and Drug Administration for cSLE treatment in children aged > 5 years. New therapies targeting CD20, such as atacicept and telitacicept, seem to be promising drugs for SLE patients. Anti-interferon therapies (sifalimumab and anifrolumab) have shown beneficial results in phase II randomized control trials in adult SLE patients, as have some Janus kinase inhibitors, and these could be alternative treatments for pediatric patients with severe interferon-mediated inflammatory disease in the future. In addition, strict control of proteinuria and blood pressure is required in cSLE, especially with angiotensin-converting enzyme inhibitor and angiotensin receptor blocker use.

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Alcohol, smoking and illicit drug use in pediatric systemic lupus erythematosus patients

Abstract: This study showed high frequencies of early alcohol use in lupus adolescents and healthy controls, despite of a possible low risk for substance abuse/dependence in childhood-onset systemic lupus erythematosus patients.

Cited by 10 publications

References 21 publications

Epidemiology and management practices for childhood-onset systemic lupus erythematosus patients: a survey in Latin America

Epidemiology and management practices for childhood-onset systemic lupus erythematosus patients: a survey in Latin America

Sexual function in female juvenile idiopathic arthritis patients

An Update on the Management of Childhood-Onset Systemic Lupus Erythematosus

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