The Diagnosis and Treatment of Systemic Lupus Erythematosus

Kuhn, Annegret; Bonsmann, Gisela; Anders, Hans‐Joachim; Herzer, P.; Tenbrock, Klaus; Schneider, Matthias

doi:10.3238/arztebl.2015.0423

Cited by 158 publications

(167 citation statements)

References 68 publications

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“…17 One female systemic lupus erythematosus case with typical malar rash, ulcerative lesions over lips, labial mucosa and tongue was screened associated with joint pain, respiratory tract infection similar to earlier reports. 4,18 One 80 year old female patient presented with ulcerative lesion over lower lip associated with burning sensation and histological features were consistent with that of discoid lupus erythematous which is similar to other studies. 4,18 Total 22 cases of premalignant conditions were diagnosed with most common etiologies being leukoplakia followed by oral submucous fibrosis.…”

Section: Fig 5: a Psoriasis Case Presented With Fissured Tonguesupporting

confidence: 71%

“…4,18 One 80 year old female patient presented with ulcerative lesion over lower lip associated with burning sensation and histological features were consistent with that of discoid lupus erythematous which is similar to other studies. 4,18 Total 22 cases of premalignant conditions were diagnosed with most common etiologies being leukoplakia followed by oral submucous fibrosis. In the present study, premalignant conditions showed association with smoking and use of other forms of tobacco with a significant male preponderance.…”

Section: Fig 5: a Psoriasis Case Presented With Fissured Tonguesupporting

confidence: 71%

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Long term cognitive outcome in herpes simplex encephalitis

Peter¹,

T.S²,

Mohiyuddin³

et al. 2020

IJN

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Introduction: Oral health is important to individuals of all age groups. The oral mucosa performs essential protective functions that plays an important role in the general health status of an individual. As a result of aging, oral epithelium undergo atrophic changes leading to decrease in tissue regeneration and disease resistance, which can expose the oral mucosa to a variety of pathogens and chemicals. In present study, we aimed to document the clinical types of oral mucosal lesions and to study its distribution and possible etiological factors in geriatric population. Materials and Methods: A total number of 5257 patients above 60 years of age were examined and 130 patients fulfilling the criteria were enrolled for the study. A written consent taken from the patients. A detailed medical history and general physical examination was done to establish the clinical diagnosis. Correlation, if any, with etiological factor was assessed. In relevant cases, necessary investigations to establish the definitive diagnosis were done. The collected data were analyzed by the SPSS 22 version software. Results: In the present study, age group of 60-69 years were commonly involved, with a male preponderance. Buccal mucosa was the most common site involved. The common risk factors observed were smoking, alcohol and betel quid chewing. The most frequent lesions found were malignancy, oral candidiasis and oral lichen planus followed by premalignant etiologies. Conclusion: This present study brings to light various oral mucosal lesions in geriatric population, which also highlights the importance of early diagnosis of oral precancerous lesions before it develops into malignancy.

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Section: Fig 5: a Psoriasis Case Presented With Fissured Tonguesupporting

confidence: 71%

Section: Fig 5: a Psoriasis Case Presented With Fissured Tonguesupporting

confidence: 71%

Long term cognitive outcome in herpes simplex encephalitis

Peter¹,

T.S²,

Mohiyuddin³

et al. 2020

IJN

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“…To date, 2 S1P (1) receptor modulators have been granted marketing authorization for the treatment of multiple sclerosis . Cenerimod is under clinical development for the treatment of systemic lupus erythematosus (SLE), a complex autoimmune disorder of chronic nature that involves autoreactive T and B lymphocytes causing inflammation and tissue damage . Preventing organ invasion and damage by reducing their tissue availability with S1P 1 receptor modulators is thus considered a promising therapeutic approach for the treatment of SLE.…”

Section: Introductionmentioning

confidence: 99%

Modelling pharmacokinetics and pharmacodynamics of the selective S1P₁ receptor modulator cenerimod in healthy subjects and systemic lupus erythematosus patients

Lott

Juif

Dingemanse

et al. 2020

Brit J Clinical Pharma

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Aims Assessment of time to attain steady state as well as drug accumulation following long‐term treatment with the selective sphingosine‐1‐phosphate 1 receptor modulator cenerimod and prediction of the incidence of low total lymphocyte (LY) counts. Differences in pharmacokinetics and pharmacodynamics based on demographic characteristics and between healthy subjects and systemic lupus erythematosus (SLE) patients were to be identified. Methods Data from 4 Phase I studies and 1 Phase II study were pooled to develop a population pharmacokinetic/pharmacodynamic model describing cenerimod concentration and its effect on LY count. Simulations addressed the objectives. Results Simulations of 365 days of treatment indicated a time to steady state of 49 days and changes in exposure of 15% beyond 35 days. For a dose of 2 mg, the predicted incidences of LY counts below 0.5 and 0.2 × 109 cells/L were 18.2 and 0.6% for healthy subjects and 25.9 and 1.0% for SLE patients, respectively. Incidence increased with higher dose and lower baseline LY counts. For body weights of 50 and 100 kg compared to 75 kg, exposure was predicted to change by +37% and −20%, respectively. Conclusion Long‐term cenerimod administration is not expected to result in exposure and LY count reduction substantially different from results of completed studies. Low LY counts are predicted to occur more frequently in SLE patients compared to healthy subjects. Dose individualization based on the model is not considered necessary. Model‐based simulations enable benefit–risk evaluations, supporting planning of late‐phase clinical studies and scientific exchange with health authorities.

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“…Patients were excluded if they presented: (1) at least one of the clinical criteria and one of the laboratory criteria for Antiphospholipid antibody syndrome [9] and/or (2) clinical and immunological criteria for Systemic Lupus Erythematous [10] or (3) any thrombophilic state.…”

Section: Patient Selectionmentioning

confidence: 99%

Adenosine Deaminase Two and Immunoglobulin M Accurately Differentiate Adult Sneddon’s Syndrome of Unknown Cause

et al. 2018

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Background: The association that exists between livedo reticularis (LR) and stroke is known as Sneddon’s syndrome (SnS). The disorder is classified as primary SnS (PSnS), if the cause remains unknown and secondary SnS. The condition is rare and it occurs mainly sporadically. In 2014, 2 independent teams described a new genetic disorder with childhood-onset, which was called deficiency of adenosine deaminase 2 (DADA2), characterized by recurrent fevers and vascular pathologic features that included LR and stroke. All the patients carried recessively inherited mutations in cat eye syndrome chromosome region candidate 1 gene (CECR1), encoding the adenosine deaminase 2 (ADA2) protein. Genetic testing is the standard for the diagnosis of DADA2. However, the diagnostic accuracy of more affordable laboratorial analysis in CECR1-mutated individuals remains to be established. We aim to determine whether plasma ADA2 activity and serum immunoglobulin M (IgM) levels can distinguish (1) DADA2 from other adult patients within the SnS spectrum, and (2) healthy CECR1 heterozygous (HHZ) from healthy controls (HC). Methods: ADA2 activity in plasma and serum IgM concentrations was measured in adult patients within the SnS spectrum, healthy first-degree relatives and HC. Genetic results were used as the reference standard. The primary outcome measures were sensitivity and specificity derived from receiver operating curve analysis. Results: A total of 73 participants were included in the study: 26 patients with PSnS with no CECR1 mutation (PSnS), 6 bi-allelic (DADA2 patients) and 7 HHZ CECR1 mutations and 34 HC. Plasma ADA2 activity and serum IgM levels were significantly lower in DADA2 patients than in PSnS. With the use of the best indexes, plasma ADA2 activity differentiated PSnS from DADA2 with a sensitivity and specificity of 100.0% and HHZ from HC with a sensitivity of 97.1% and specificity of 85.7%. Serum IgM levels also differentiated PSnS from DADA2 with a sensitivity of 85.2% and specificity of 83.3%. Conclusion: Serum IgM levels might be used as a triage tool and plasma ADA2 activity performs perfectly as a diagnostic test for DADA2 in adult patients within the SnS spectrum. ADA2 activity in plasma also reliably distinguishes HHZ from HC.

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The Diagnosis and Treatment of Systemic Lupus Erythematosus

Abstract: The long-term prognosis for SLE has improved markedly in recent decades because of earlier diagnosis and optimized treatment. Further research and randomized controlled trials are needed for the development of specifically targeted therapies.

Cited by 158 publications

References 68 publications

Long term cognitive outcome in herpes simplex encephalitis

Long term cognitive outcome in herpes simplex encephalitis

Modelling pharmacokinetics and pharmacodynamics of the selective S1P₁ receptor modulator cenerimod in healthy subjects and systemic lupus erythematosus patients

Adenosine Deaminase Two and Immunoglobulin M Accurately Differentiate Adult Sneddon’s Syndrome of Unknown Cause

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The Diagnosis and Treatment of Systemic Lupus Erythematosus

Abstract: The long-term prognosis for SLE has improved markedly in recent decades because of earlier diagnosis and optimized treatment. Further research and randomized controlled trials are needed for the development of specifically targeted therapies.

Cited by 158 publications

References 68 publications

Long term cognitive outcome in herpes simplex encephalitis

Long term cognitive outcome in herpes simplex encephalitis

Modelling pharmacokinetics and pharmacodynamics of the selective S1P1 receptor modulator cenerimod in healthy subjects and systemic lupus erythematosus patients

Adenosine Deaminase Two and Immunoglobulin M Accurately Differentiate Adult Sneddon’s Syndrome of Unknown Cause

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Product

Resources

About

Modelling pharmacokinetics and pharmacodynamics of the selective S1P₁ receptor modulator cenerimod in healthy subjects and systemic lupus erythematosus patients