Patterns of disease activity in systemic lupus erythematosus

Barr, Susan G.; Zonana-Nacach, Abraham; Magder, Laurence S.; Petri, Michelle

doi:10.1002/1529-0131(199912)42:12<2682::aid-anr26>3.0.co;2-6

Cited by 170 publications

(121 citation statements)

References 15 publications

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“…To ensure the incident nature of the cases, we chose a 2-year diagnostic-free period before the diagnosis because the mean interval between first symptoms and effective diagnosis is ϳ2 years (31). The sensitivity analysis with Ն3 years of followup before the incident diagnosis found similar results.…”

Section: Discussionmentioning

confidence: 98%

Combined oral contraceptive use and the risk of systemic lupus erythematosus

Bernier

Mikaeloff

Hudson

et al. 2009

Arthritis & Rheumatism

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Section: Discussionmentioning

confidence: 98%

Combined oral contraceptive use and the risk of systemic lupus erythematosus

Bernier

Mikaeloff

Hudson

et al. 2009

Arthritis & Rheumatism

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“…A complete responder was defined as having no disease activity and receiving physiologic or lower doses of prednisone and no other immunosuppressive drugs. Complete and partial responders were both defined using the Responder Index for Lupus Erythematosus (RIFLE) (24). For renal lupus, a partial response required a reduction of at least 50% in the 24-hour total protein excretion.…”

Section: Methodsmentioning

confidence: 99%

High‐dose cyclophosphamide without stem cell transplantation in systemic lupus erythematosus

Petri

Jones

Brodsky

2003

Arthritis & Rheumatism

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138

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Objective. High-dose chemotherapy followed by hematopoietic stem cell transplantation is increasingly being studied as a treatment for severe autoimmune disorders, such as systemic lupus erythematosus (SLE). High-dose cyclophosphamide, the foundation of virtually all conditioning regimens for stem cell transplantation, is not myeloablative; therefore, when high-dose cyclophosphamide is used alone, autografting, with its potential for reinfusing autoreactive effector cells, is not required. We undertook this study to investigate the safety and efficacy of high-dose cyclophosphamide without stem cell transplantation in refractory SLE.Methods. We treated 14 patients with moderateto-severe SLE that had been refractory to corticosteroids and one or more additional immunosuppressive drugs. All patients received 50 mg/kg of cyclophosphamide for 4 consecutive days followed by 5 g/kg granulocyte colony-stimulating factor until the neutrophil count was 1 ؋ 10 9 /liter for 2 consecutive days. Patients were followed up monthly for disease activity using the physician's global assessment, SLE Disease Activity Index, and assessment of functioning of involved organs. The Responder Index for Lupus Erythematosus was used to define partial or complete response.Results. The median time to achieve a neutrophil count of 0.5 ؋ 10 9 /liter was 14 days (range 11-22 days) after the last dose of cyclophosphamide. Patients required a median of 2 units (range 2-5) of packed red blood cells, and a median of 16 days (range 0-23 days) elapsed from the last dose of cyclophosphamide to the last platelet transfusion. There were no deaths or fungal infections. Significant improvements in physician's global assessment (mean difference 1.4; P < 0.0001), SLE Disease Activity Index (mean difference 4.1; P ‫؍‬ 0.0039), and prednisone dosage (mean difference 14.9 mg/day; P ‫؍‬ 0.002) were observed. Responses, including 5 durable complete responses, were observed in all organ systems (renal, central nervous system, and skin) with involvement that had led to patient enrollment.Conclusion. High-dose cyclophosphamide without stem cell transplantation leads to rapid hematopoietic reconstitution and has significant clinical benefit in patients with refractory SLE. Therefore, this approach deserves further study.Despite improved survival rates in patients with systemic lupus erythematosus (SLE) and other autoimmune disorders, there remains a subset of patients in whom the disease is refractory to therapy or who require toxic dosages of immunosuppressive drugs. Standard therapy for severe renal or central nervous system (CNS) SLE is monthly intravenous (IV) bolus cyclophosphamide in doses of 500-1,000 mg/m 2 body surface area. The superior efficacy of this therapy compared with corticosteroids alone has been proven for diffuse proliferative glomerulonephritis (1,2) and has been suggested in case series of SLE with CNS involvement (3). Monthly IV bolus cyclophosphamide has a safety profile superior to that of daily oral cyclophosphamide, but important toxicitie...

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“…24 Salah satu ciri khas penyakit LES adalah aktivitas penyakit yang berubah-ubah sepanjang perjalanan penyakit. 25 Sistem skor SLEDAI penting untuk membantu menilai aktivitas penyakit dan menentukan terapi yang akan diberikan pada pasien LES. 21 Penilaian skor SLEDAI dapat dilakukan setiap 3-6 bulan atau ketika ada perubahan aktivitas penyakit.…”

Section: Hasil Berbeda Didapatkan Oleh Gonzalez Dkkunclassified

Penilaian Aktivitas Penyakit Lupus Eritematosus Sistemik dengan Skor SLEDAI di Departemen Ilmu Kesehatan Anak RSCM

Saleh

Kurniati

Syarif

2016

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Latar belakang. Keberhasilan tata laksana penyakit lupus eritematosus sistemik (LES) memerlukanpemantauan tertentu. Skor systemic lupus erythematosus disease activity index (SLEDAI) adalah alat ukuryang dapat digunakan untuk tata laksana sehari-hari. Saat ini belum ada data mengenai pemantauan aktivitaspenyakit LES anak menggunakan skor SLEDAI dengan rentang waktu tertentu.Tujuan. Memantau aktivitas penyakit LES anak dengan skor SLEDAI setiap 3 bulan selama satu tahunpengamatan.Metode. Studi deskriptif retrospektif menggunakan data rekam medik dari 01 Juli 2005 sampai dengan31 Juli 2013.Hasil. Tigapuluh rekam medik memenuhi kriteria penelitian. Manifestasi awal tersering berdasarkan skorSLEDAI adalah artritis, rash, demam, peningkatan dsDNA, dan komplemen darah rendah. Perubahan skorSLEDAI terutama terlihat pada pengamatan antara bulan ke-0 dengan bulan ke-3. Pada awal pengamatan,mayoritas pasien termasuk high activity, tetapi pada akhir pengamatan menjadi no activity.Kesimpulan. Penilaian skor SLEDAI setiap 3 bulan dapat digunakan untuk memantau aktivitas penyakitLES anak.

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Patterns of disease activity in systemic lupus erythematosus

Cited by 170 publications

References 15 publications

Combined oral contraceptive use and the risk of systemic lupus erythematosus

Combined oral contraceptive use and the risk of systemic lupus erythematosus

High‐dose cyclophosphamide without stem cell transplantation in systemic lupus erythematosus

Penilaian Aktivitas Penyakit Lupus Eritematosus Sistemik dengan Skor SLEDAI di Departemen Ilmu Kesehatan Anak RSCM

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