First Latin American clinical practice guidelines for the treatment of systemic lupus erythematosus: Latin American Group for the Study of Lupus (GLADEL, Grupo Latino Americano de Estudio del Lupus)–Pan-American League of Associations of Rheumatology (PANLAR)

Abstract

Systemic lupus erythematosus (SLE), a complex and heterogeneous autoimmune disease, represents a significant challenge for both diagnosis and treatment. Patients with SLE in Latin America face special problems that should be considered when therapeutic guidelines are developed. The objective of the study is to develop clinical practice guidelines for Latin American patients with lupus. Two independent teams (rheumatologists with experience in lupus management and methodologists) had an initial meeting in Panama City, Panama, in April 2016. They selected a list of questions for the clinical problems most commonly seen in Latin American patients with SLE. These were addressed with the best available evidence and summarised in a standardised format following the Grading of Recommendations Assessment, Development and Evaluation approach. All preliminary findings were discussed in a second face-to-face meeting in Washington, DC, in November 2016. As a result, nine organ/system sections are presented with the main findings; an ‘overarching’ treatment approach was added. Special emphasis was made on regional implementation issues. Best pharmacologic options were examined for musculoskeletal, mucocutaneous, kidney, cardiac, pulmonary, neuropsychiatric, haematological manifestations and the antiphospholipid syndrome. The roles of main therapeutic options (ie, glucocorticoids, antimalarials, immunosuppressant agents, therapeutic plasma exchange, belimumab, rituximab, abatacept, low-dose aspirin and anticoagulants) were summarised in each section. In all cases, benefits and harms, certainty of the evidence, values and preferences, feasibility, acceptability and equity issues were considered to produce a recommendation with special focus on ethnic and socioeconomic aspects. Guidelines for Latin American patients with lupus have been developed and could be used in similar settings.

Mechanisms of action of hydroxychloroquine and chloroquine: implications for rheumatology

“…1). Neither chloroquine nor hydroxychloro quine underwent conventional drug development, but their use has become a part of current treatment guide lines for rheumatoid arthritis (RA) 1 , systemic lupus eryth ematosus (SLE) [2][3][4] , antiphospholipid syndrome (APS) 5 and primary Sjögren syndrome 6,7 .…”

Prospects for Anti-B-Cell Therapy in Immuno-Inflammatory Rheumatic Diseases

“…РТМ широко и с большим успехом используется при СКВ в клинической практике [108] и включен в международные [109][110][111][112][113] рое вошли пациенты с активной СКВ без поражения почек, и LUNAR (Lupus Nephritis Assesment with Rituximab) [116] -с волчаночным нефритом (ВН), «первичные конечные точки», отражающие эффективность терапии, достигнуты не были (табл. 7).…”

Chloroquine drug and Graphene complex for treatment of COVID-19

“…Recent studies have shown that this drug successfully treats patients with coronavirus pneumonia 11 . Also, the chloroquine drug has potential applications in the treatment of diseases such as rheumatoid arthritis (RA) 13 , systemic lupus erythematosus (SLE) [14][15][16] , antiphospholipid syndrome (APS) 17 and primary Sjogren syndrome 18 . Previous studies have shown that chloroquine has an antiviral mechanism and by increasing the pH, it prevents unwanted viruses such as human immunodeficiency virus (HIV) 19 , Zika virus 20,21 , Ebola virus 22 and the avian leucosis virus 23 from entering the cell.…”