Cardiovascular Outcomes in Systemic Lupus Erythematosus

Sairam, Shrilekha; Sureen, Amit; Gutiérrez, Julián; Dang, The Q; Mishra, Kunal

doi:10.1007/s11886-021-01626-9

Cited by 3 publications

(1 citation statement)

References 63 publications

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“…Among the leading contributors to morbidity and mortality in SLE are infection and CV disease [28]. The incidences of myocardial infarction (MI), stroke, and heart failure are highest in the first year following diagnosis, decrease in the following years, then rise again 10-15 years following diagnosis [29]. A meta-analysis of CV risk in SLE and LN demonstrated a doubling of the relative risk (RR) compared to the general population (RR 2.35, 95% CI: 1.95-2.84, P < 0.05).…”

Section: What Is the Impetus To Use Sodium-glucose Cotransporter 2 In...mentioning

confidence: 99%

Sodium-glucose cotransporter 2 inhibitors: are they ready for prime time in the management of lupus nephritis?

Wagner,

Rao

2024

Current Opinion in Rheumatology

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Purpose of review Lupus nephritis is a common complication of systemic lupus erythematosus and is associated with significant morbidity and mortality. The utility of sodium-glucose cotransporter 2 (SGLT2) inhibitors in the management of lupus nephritis is currently uncertain. Here, we summarize the rationale for their use among patient with lupus nephritis. Recent findings SGLT2 inhibitors were initially developed as antihyperglycemic agents. They have since been shown to have additional, profound effects to slow the progression of chronic kidney disease and lessen the long-term risks of cardiovascular disease in large clinic trials of patients with chronic kidney disease, with and without diabetes, as well as in patients with and without proteinuria. Patients with recent exposure to immunosuppression were excluded from these trials due to concern for risk of infection. In the few, small trials of patients with lupus nephritis, SGLT2 inhibitors were found to be well tolerated. They have been shown to reduce proteinuria and to have modest beneficial effects on blood pressure and BMI among patients with lupus nephritis. They have not been shown to influence disease activity. Summary SGLT2 inhibitors may have a role in mitigating the chronic renal and cardiovascular effects of lupus nephritis. They should be introduced after kidney function has been stabilized with appropriate immunosuppression, in conjunction with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. They currently have no role in active disease.

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Section: What Is the Impetus To Use Sodium-glucose Cotransporter 2 In...mentioning

confidence: 99%

Sodium-glucose cotransporter 2 inhibitors: are they ready for prime time in the management of lupus nephritis?

Wagner,

Rao

2024

Current Opinion in Rheumatology

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Efficacy and Safety of Upadacitinib or Elsubrutinib Alone or in Combination for Patients With Systemic Lupus Erythematosus: A Phase 2 Randomized Controlled Trial

Merrill,

Tanaka,

D'Cruz

et al. 2024

Arthritis & Rheumatology

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ObjectiveThe 48‐week, phase 2 SLEek study (NCT03978520) evaluated the efficacy and safety of upadacitinib (Janus kinase inhibitor) and elsubrutinib (Bruton's tyrosine kinase inhibitor) alone or in combination (ABBV‐599) in adults with moderately to severely active systemic lupus erythematosus (SLE).MethodsPatients were randomized 1:1:1:1:1 to once‐daily (QD) ABBV‐599 high dose (HD; elsubrutinib 60mg + upadacitinib 30mg), ABBV‐599 low dose (LD; elsubrutinib 60mg + upadacitinib 15mg), elsubrutinib 60mg, upadacitinib 30mg, or placebo. The primary endpoint was the proportion of patients achieving both SLE Responder Index‐4 (SRI‐4) and glucocorticoid dose ≤10mg QD at week 24. Additional assessments through week 48 included British Isles Lupus Assessment Group‐based Composite Lupus Assessment (BICLA) and Lupus Low Disease Activity State (LLDAS) responses, number of flares, time to first flare, and adverse events.ResultsThe study enrolled 341 patients. The ABBV‐599LD and elsubrutinib arms were discontinued after a planned interim analysis showed lack of efficacy (no safety concerns). More patients achieved the primary endpoint with upadacitinib (54.8%; P=0.028) and ABBV‐599HD (48.5%; P=0.081) versus placebo (37.3%). SRI‐4, BICLA, and LLDAS response rates were higher for both upadacitinib and ABBV‐599HD versus placebo at weeks 24 and 48. Flares were reduced and time to first flare through week 48 was substantially delayed with both upadacitinib and ABBV‐599HD versus placebo. No new safety signals were observed beyond those previously reported for upadacitinib or elsubrutinib.ConclusionsUpadacitinib 30mg alone or in combination with elsubrutinib (ABBV‐599HD) demonstrated significant improvements in SLE disease activity, reduced flares and were well tolerated through 48 weeks.image

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Hallazgos ecocardiográficos en pacientes con lupus eritematoso sistémico: análisis retrospectivo en un centro de referencia terciaria

Aguilar-Molina

Quintero-González

Corredor-Castro

et al. 2024

Revista Colombiana de Reumatología

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Cardiovascular Outcomes in Systemic Lupus Erythematosus

Cited by 3 publications

References 63 publications

Sodium-glucose cotransporter 2 inhibitors: are they ready for prime time in the management of lupus nephritis?

Sodium-glucose cotransporter 2 inhibitors: are they ready for prime time in the management of lupus nephritis?

Efficacy and Safety of Upadacitinib or Elsubrutinib Alone or in Combination for Patients With Systemic Lupus Erythematosus: A Phase 2 Randomized Controlled Trial

Hallazgos ecocardiográficos en pacientes con lupus eritematoso sistémico: análisis retrospectivo en un centro de referencia terciaria

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