Prevention of relapses in systemic lupus erythematosus

Bootsma, Hendrika; Spronk, Peter E.; Boer, G. de; Limburg, P. C.; Kallenberg, Cees G. M.; Derksen, R. H. W. M.; Wolters-Dicke, J.; Gmelig-Meyling, F.H.J.; Kater, L.; Hermans, J.

doi:10.1016/s0140-6736(95)90114-0

Cited by 252 publications

(150 citation statements)

References 25 publications

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“…In the case where one time interval had more than one positive sample, those values closest to diagnosis were selected for analysis. Consistent with other reports [6,14], changes in anti-dsDNA antibody levels $ 25% were considered significant. Wilcoxon signed rank test, chi-square, and Fisher's Exact test were used for analyzing categorical differences.…”

Section: Methodssupporting

confidence: 82%

“…Furthermore, treatment of patients when anti-dsDNA antibody levels start to rise can be effective in preventing a significant number of relapses. In a recent study by Bootsma et al [14] patients demonstrating a significant ($25%) rise in anti-dsDNA antibodies were randomly assigned to receive conventional treatment or 30 mg of prednisone added to the existing regimen. Time is presented in years prior to diagnosis.…”

Section: Discussionmentioning

confidence: 99%

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Development of Anti‐dsDNA Autoantibodies Prior to Clinical Diagnosis of Systemic Lupus Erythematosus

et al. 2001

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Anti‐double stranded (dsDNA) antibodies are of considerable diagnostic value and are thought to be involved in the pathogenesis of systemic lupus erythematosus (SLE). Fluctuations in anti‐dsDNA antibody levels are also used as markers for disease activity and exacerbations. In this study we sought to evaluate the anti‐dsDNA antibody level in serum samples collected before the onset of SLE diagnosis. A total of 130 SLE patients were identified with stored serum samples available prior to diagnosis within the US Department of Defense serum repository. All 633 sera available from these patients were screened for anti‐dsDNA antibodies using an enzyme linked immunosorbant assay (ELISA). Within this cohort 55% of cases had detectable anti‐dsDNA antibodies prior to SLE diagnosis. The onset of anti‐dsDNA antibodies ranged from 9.3 years before to within the same month as diagnosis (with a mean onset 2.7 years before diagnosis). In order to assess for fluctuations in anti‐dsDNA levels relative to diagnosis, cases were selected with at least two positive samples, one within 6 months and a second greater than 6 months prior to diagnosis (n = 26). Seven of these cases also had samples available shortly after diagnosis (≤ 6 months) for comparison. Fifty‐eight percent of the 26 cases developed a significant rise in anti‐dsDNA antibody levels within 6 months of diagnosis. A significant decline in anti‐dsDNA levels ensued after diagnosis (and following treatment with corticosteroids) in all seven cases with samples available. Patients with a significant rise in anti‐dsDNA antibodies at diagnosis were more likely to have renal disease than those who did not (66.7% compared to 27.3%, χ2=3.94, P<0.05). These data suggest that anti‐dsDNA antibodies are present in SLE patient sera much earlier than previously suspected. In addition, the data are consistent with increases in anti‐dsDNA levels contributing to the onset of clinical illness in some patients with SLE.

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Section: Methodssupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Development of Anti‐dsDNA Autoantibodies Prior to Clinical Diagnosis of Systemic Lupus Erythematosus

et al. 2001

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“…It is not clear which disease-related or kidney-associated parameter correlates best with long-term outcome, particularly the development of ESRD. In previous studies, factors that have been associated with worse renal outcomes over the long term have included elevated titers of anti-double-stranded DNA (anti-dsDNA) antibodies (7)(8)(9)(10)(11), low levels of C3 complement (11)(12)(13)(14)(15), 422 RENAL DISEASE SUBCOMMITTEE OF THE ACR AD HOC COMMITTEE ON SLE RESPONSE CRITERIA increased levels of serum creatinine (3,8,9,12,13,, decreased rates of creatinine clearance (11,23,31,36,37), the presence of extrarenal manifestations (38,39), the number of lupus flares (9,28,35), the presence of hypertension (12,13,18,21,30,31,35,36,(40)(41)(42)(43), the presence of nephrotic syndrome (31,(44)(45)(46), an increased activity index on histologic assessment of renal biopsy tissues (9,12,…”

Section: Resultsmentioning

confidence: 99%

“…The committee defined worsened as a Ն25% decline in the estimated GFR. This value was based on the consensus of the literature that was reviewed (10,30,42,(72)(73)(74)(75)(76)(77)(78)(79)(80), where the definition of worsened ranged from a decrease in creatinine clearance of 10 ml/minute to a decrease of 30%. These changes may not predict long-term renal outcome.…”

Section: Resultsmentioning

confidence: 99%

The American college of rheumatology response criteria for proliferative and membranous renal disease in systemic lupus erythematosus clinical trials

Liang

Schur

Fortin

et al. 2006

Arthritis & Rheumatism

229

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“…Corticosteroids are effective at treating disease flares (3,4), but their long-term use is associated with severe comorbidities (5). Treatments that are targeted and control disease activity while allowing the taper of corticosteroid dosages would represent an advance in lupus therapy.…”

mentioning

confidence: 99%

The efficacy and safety of abatacept in patients with non–life‐threatening manifestations of systemic lupus erythematosus: Results of a twelve‐month, multicenter, exploratory, phase IIb, randomized, double‐blind, placebo‐controlled trial

Merrill¹,

Burgos‐Vargas²,

Westhovens³

et al. 2010

Arthritis & Rheumatism

344

180

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Objective. To evaluate abatacept therapy in patients with non-life-threatening systemic lupus erythematosus (SLE) and polyarthritis, discoid lesions, or pleuritis and/or pericarditis.Methods. In a 12-month, multicenter, exploratory, phase IIb randomized, double-blind, placebocontrolled trial, SLE patients with polyarthritis, discoid lesions, or pleuritis and/or pericarditis were randomized at a ratio of 2:1 to receive abatacept (ϳ10 mg/kg of body weight) or placebo. Prednisone (30 mg/day or equivalent) was given for 1 month, and then the dosage was tapered. The primary end point was the proportion of patients with new flare (adjudicated) according to a score of A/B on the British Isles Lupus Assessment Group (BILAG) index after the start of the steroid taper. Results

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Prevention of relapses in systemic lupus erythematosus

Cited by 252 publications

References 25 publications

Development of Anti‐dsDNA Autoantibodies Prior to Clinical Diagnosis of Systemic Lupus Erythematosus

Development of Anti‐dsDNA Autoantibodies Prior to Clinical Diagnosis of Systemic Lupus Erythematosus

The American college of rheumatology response criteria for proliferative and membranous renal disease in systemic lupus erythematosus clinical trials

The efficacy and safety of abatacept in patients with non–life‐threatening manifestations of systemic lupus erythematosus: Results of a twelve‐month, multicenter, exploratory, phase IIb, randomized, double‐blind, placebo‐controlled trial

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