EULAR recommendations for the management of systemic lupus erythematosus. Report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics
George Bertsias,John P. A. Ioannidis,John Boletis,Stefano Bombardieri,Ricard Cervera,C. Dostal,J Font,Inge-Magrethe Gilboe,F. Houssiau,Twj Huizinga,David A. Isenberg,Cees G. M. Kallenberg,Munther A. Khamashta,J.C. Piette,Matthias Schneider,Matthias Schneider,Josef S Smolen,Gunnar Sturfelt,Angela Tincani,R. van Vollenhoven,Caroline Gordon,Dimitrios T. Boumpas +21 more
TLDR
Recommendations for the management of SLE were developed using an evidence-based approach followed by expert consensus with high level of agreement among the experts.Abstract:
Objective: Systemic lupus erythematosus (SLE) is a complex disease with variable presentations, course and prognosis. We sought to develop evidence-based recommendations addressing the major issues in the management of SLE. Methods: The EULAR Task Force on SLE comprised 19 specialists and a clinical epidemiologist. Key questions for the management of SLE were compiled using the Delphi technique. A systematic search of PubMed and Cochrane Library Reports was performed using McMaster/Hedges clinical queries' strategies for questions related to the diagnosis, prognosis, monitoring and treatment of SLE. For neuropsychiatric, pregnancy and antiphospholipid syndrome questions, the search was conducted using an array of relevant terms. Evidence was categorised based on sample size and type of design, and the categories of available evidence were identified for each recommendation. The strength of recommendation was assessed based on the category of available evidence, and agreement on the statements was measured across the 19 specialists. Results: Twelve questions were generated regarding the prognosis, diagnosis, monitoring and treatment of SLE, including neuropsychiatric SLE, pregnancy, the antiphospholipid syndrome and lupus nephritis. The evidence to support each proposition was evaluated and scored. After discussion and votes, the final recommendations were presented using brief statements. The average agreement among experts was 8.8 out of 10. Conclusion: Recommendations for the management of SLE were developed using an evidence-based approach followed by expert consensus with high level of agreement among the experts.read more
Citations
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Efficacy and safety of belimumab in patients with active systemic lupus erythematosus: a randomised, placebo-controlled, phase 3 trial
Sandra V. Navarra,Renato Guzman,Alberto E. Gallacher,Stephen B. Hall,Roger A. Levy,Renato E. Jimenez,Edmund K. Li,Mathew Thomas,Ho-Youn Kim,Manuel G. León,Coman Tanasescu,Eugeny L. Nasonov,Joung-Liang Lan,Lilia Pineda,Z. John Zhong,William W. Freimuth,Michelle A. Petri +16 more
TL;DR: The efficacy and safety of the fully human monoclonal antibody belimumab (BLyS-specific inhibitor) was assessed in patients with active systemic lupus erythematosus in a multicentre phase 3 study done in Latin America, Asia-Pacific, and eastern Europe.
Journal ArticleDOI
2019 update of the EULAR recommendations for the management of systemic lupus erythematosus
Antonis Fanouriakis,Myrto Kostopoulou,Alessia Alunno,Martin Aringer,Ingeborg M. Bajema,John Boletis,Ricard Cervera,Andrea Doria,Caroline Gordon,Marcello Govoni,Frédéric Houssiau,David Jayne,Marios Kouloumas,Annegret Kuhn,Janni Lisander Larsen,Kirsten Lerstrøm,Gabriella Moroni,Marta Mosca,Matthias Schneider,Josef S Smolen,Elisabet Svenungsson,Vladimir Tesar,Angela Tincani,Anne Troldborg,Ronald F van Vollenhoven,Jörg Wenzel,George Bertsias,Dimitrios T. Boumpas +27 more
TL;DR: The updated recommendations provide physicians and patients with updated consensus guidance on the management of SLE, combining evidence-base and expert-opinion, based on emerging new evidence.
Journal ArticleDOI
Joint European League Against Rheumatism and European Renal Association–European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of adult and paediatric lupus nephritis
George Bertsias,Maria G Tektonidou,Zahir Amoura,Martin Aringer,Ingeborg M. Bajema,Jo H. M. Berden,John Boletis,Ricard Cervera,Thomas Dörner,Andrea Doria,Franco Ferrario,Jürgen Floege,Frédéric Houssiau,John P. A. Ioannidis,David A. Isenberg,Cees G. M. Kallenberg,Liz Lightstone,Stephen D. Marks,Alberto Martini,G. Moroni,Irmgard Neumann,Manuel Praga,Matthias Schneider,Argyre Starra,Vladimir Tesar,Carlos Vasconcelos,Ronald F van Vollenhoven,Helena Zakharova,Marion Haubitz,Caroline Gordon,David Jayne,Dimitrios T. Boumpas +31 more
TL;DR: Recommendations for the management of lupus nephritis were developed using an evidence-based approach followed by expert consensus and there is no evidence to suggest that management of LN should differ in children versus adults.
Journal ArticleDOI
Clinical efficacy and side effects of antimalarials in systemic lupus erythematosus: a systematic review
TL;DR: High levels of evidence were found that AMs prevent lupus flares and increase long-term survival of patients with SLE; moderate evidence of protection against irreversible organ damage, thrombosis and bone mass loss and evidence supporting an effect on severe l upus activity, lipid levels and subclinical atherosclerosis was weak.
Journal ArticleDOI
Systemic lupus erythematosus.
Arvind Kaul,Caroline Gordon,Mary K. Crow,Zahi Touma,Murray B. Urowitz,Ronald F van Vollenhoven,Guillermo Ruiz-Irastorza,Graham R. V. Hughes +7 more
TL;DR: The 10-year mortality has improved and toxic adverse effects of older medications such as cyclophosphamide and glucocorticoids have been partially offset by newer drugs such as mycophenolate mofetil and glucose-sparing regimes.
References
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Comparison of Mortality in All Patients on Dialysis, Patients on Dialysis Awaiting Transplantation, and Recipients of a First Cadaveric Transplant
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TL;DR: In this paper, the authors conducted a longitudinal study of mortality in 228,552 patients who were receiving long-term dialysis for end-stage renal disease, and 46,164 were placed on a waiting list for transplantation, 23,275 of whom received a first cadaveric transplant between 1991 and 1997.
Book
Systemic Lupus Erythematosus
TL;DR: Contributions are gathered from physicians and researchers from North America, South America, Europe, and Asia that highlight several important and/or novel aspects of the molecular pathogenesis, clinical organ involvement, and experimental therapies in this prototypical systemic autoimmune disease.
Competing interests: none declared.
TL;DR: a Executive Director, Medical Communications, Merck Research Laboratories, 126 E. Lincoln Ave., Rahway, NJ 07065, USA (email: laurence_hirsch@merck.com).
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The Management of Thrombosis in the Antiphospholipid-Antibody Syndrome
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TL;DR: The risk of recurrent thrombosis in patients with the antiphospholipid-antibody syndrome is high and long-term anticoagulation therapy in which the international normalized ratio is maintained at or above 3 is advisable in these patients.
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