Systemic lupus erythematosus

(Refractory to mycophenolate, azathioprine, and methotrexate. UpToDate suggests thalidomide or IVIG with mixed efficacy, while there are some case rep...

4 Answers available

In your experience, is there an association between interstitial cystitis and systemic lupus erythematosus?

2 Answers available

Do you find IgA isotypes of anti-beta2-glycoprotein antibodies and anticardiolipin antibodies to be clinically useful in the evaluation for APS?

Do you routinely check IgA anticardiolipin and beta-2 glycoprotein antibody IgA in your practice? And how would a positive result change your manageme...

2 Answers available

How do you treat lupus-associated small fiber neuropathy?

1 Answer available

What do you view as reasonable alternatives to cyclophosphamide in the treatment of neuropsychiatric lupus?

4 Answers available

Do you ever consider treatment outside of the peripartum period in a patient with a history of obstetric APS?

i.e. obstretric APS without thrombosis or SLE

2 Answers available

How do you approach the management of immunosuppression in patients with lupus nephritis that go on to dialysis?

3 Answers available

What is your approach to treating severe manifestations of neuropsychiatric SLE in the setting of concomitant infection?

1 Answer available

Is there a role for immunosuppression in patients with triple positive antiphospholipid antibodies who do not meet the clinical criteria for APS?

2 Answers available

What particular pre-operative considerations should we consider for SLE patients undergoing elective surgery?

1 Answer available

How do you approach DMARD therapy in a patient with lupus and recurrent pericarditis?

1 Answer available

How do you approach the use of commercial testing such as AVISE CTD in clinical practice?

1 Answer available

How will you utilize newly FDA approved anifrolumab for SLE in your practice?

2 Answers available

Do you measure drug levels (particularly hydroxychloroquine or mycophenolate) in your lupus patients?

Several speakers at ACR 2021 commented on the important role of drug levels in the management of these patients and cautioned against adding medicatio...

1 Answer available

How do you approach immunosuppressive therapy in lupus-associated pulmonary arterial hypertension?

2 Answers available

Would you use voclosporin or belimumab as adjunctive therapy for treatment of lupus nephritis?

Especially given the recent FDA approval of voclosporin, how should we think about the use of this medication for LN?

3 Answers available

How do you clinically distinguish between cutaneous lupus with photosensitivity and polymorphic light eruption-like reactions?

1 Answer available

Is it ever reasonable to switch to a different TNFi as opposed to switching to an agent in a different class in a case of TNFi induced lupus or psoriasis?

In other words, do we think of TNFi induced lupus and TNFi induced psoriasis as a drug effect or a class effect?

1 Answer available

What is your approach to differentiating SLE flare in pregnancy vs pre-eclampsia?

1 Answer available

What is your approach to monitoring lipids in patients with rheumatic diseases such as RA and SLE and do you have a lower threshold to start lipid lowering agents compared to the general population?

2 Answers available

What do you use for treatment induction in pure class V lupus nephritis with nephrotic-range proteinuria when MMF is contraindicated?

2 Answers available

Is there a role for measuring serum mycophenolate mofetil levels (or its active metabolite) in the management of lupus nephritis?

1 Answer available

Does the presence of ANCA antibodies in patients with newly diagnosed lupus nephritis alter your approach to management?

1 Answer available

How would you approach localized lymphadenopathy in a patient with lupus whose symptoms are otherwise well-controlled?

2 Answers available

How do you approach monitoring of patients found to have a positive anti-dsDNA antibody without other clinical evidence of SLE?

1 Answer available

How would you advise patients with known stable autoimmune thrombocytopenia regarding the Ad26.COV2.S (Johnson & Johnson/Janssen) vaccine?

1 Answer available

How do you approach the use of low-dose aspirin for primary prevention in non-pregnant patients with SLE and positive aPL antibodies, without clinical criteria for APS?

Do you follow the 2019 EULAR Guidelines that SLE patients with asymptomatic, positive aPL should be on low-dose ASA?

1 Answer available

How useful are anti-ribosomal P antibodies in the evaluation for SLE psychosis?

1 Answer available

When is it necessary to monitor the QTc interval in patients on hydroxychloroquine?

2 Answers available

Is it okay to use medications associated with drug-induced lupus in patients with SLE?

1 Answer available

Is there a role for G-CSF treatment for SLE patients with persistent neutropenia?

1 Answer available

What is your approach to treatment of lupus peritonitis?

1 Answer available

Is there a role for measuring hydroxychloroquine blood levels in clinical practice?

If so, are there specific patient populations for which you would use this metric?

1 Answer available

What is your threshold for pursuing bone marrow biopsy in a lupus patient with cytopenias?

2 Answers available

Are you recommending the mRNA COVID-19 vaccines to your patients with immune mediated inflammatory diseases?

5 Answers available

What is your approach to treating refractory thrombocytopenia in lupus?

2 Answers available

Which immunosuppressed patients with SLE would benefit from antibiotic prophylaxis to prevent pneumocystis pneumonia?

1 Answer available

Is it ever appropriate to use hydroxychloroquine temporarily in higher doses (more than 5mg/kg) to control lupus activity such as skin manifestations?

1 Answer available

How do you interpret a high positive RNP in the setting of a negative ANA and negative sm/RNP?

To my understanding, sm/RNP should also be positive in this situation (and one would assume a positive ANA as well)

1 Answer available

How would you attempt to determine the etiology of intracranial hemorrhage in a patient with newly diagnosed lupus and an active viral infection?

1 Answer available

What is your first choice contraceptive agent for women with SLE?

How do you counsel these patients about hormonal agents?

1 Answer available

Is it okay to use belimumab to treat SLE in a patient who has a history of lymphoma and is on a Bruton's tyrosine kinase inhibitor (such as ibrutinib)?

1 Answer available

Do you think there is a role for belimumab in treating lupus nephritis and if so, in which patients would you considering adding it on?

Did the recently published BLISS-LN trial change your practice?

2 Answers available

Does serologic activity (e.g., high titer dsDNA, low complements) without clinical disease activity in a pregnant lupus patient affect maternal or fetal outcomes?

2 Answers available

Do you continue hydroxychloroquine in lupus patients who develop cardiomyopathy?

1 Answer available

Should gonadotropin-releasing hormone (GnRH) agonists be offered to all women of reproductive age about to undergo treatment with cyclophosphamide?

2 Answers available

What is your approach to bladder cancer surveillance in patients who have received cyclophosphamide?

1 Answer available

How do steroids and/or DMARDs affect biopsy results if a renal biopsy for suspected lupus nephritis is delayed?

1 Answer available

Are there any clinical situations in which checking for anti-chromatin antibodies is helpful?

1 Answer available

Do you choose rituximab or calcineurin inhibitors for patients with class IV/V lupus nephritis who are refractory to standard of care therapies?

1 Answer available

How do you counsel patients who ask if there are any dietary modifications they can make to help control their autoimmune disease?

1 Answer available

Is there a minimum work-up necessary in patients with an ANA greater than 1:160 and no clinical symptoms suggestive of lupus (i.e., specific antibodies, UA)?

2 Answers available

Do you use hydroxychloroquine for prevention of neonatal lupus in patients with a positive SSA who are planning on becoming pregnant?

1 Answer available

In the treatment of lupus nephritis, which patients may benefit from the use of rituximab or other B-cell depleting agents during induction?

1 Answer available

Papers discussed in this category

Arthritis and rheumatism, 2012-04

Efficacy and safety of rituximab in patients with active proliferative lupus nephritis: the Lupus Nephritis Assessment with Rituximab study.

Ann Rheum Dis, 2013 Jun 05

Prospective observational single-centre cohort study to evaluate the effectiveness of treating lupus nephritis with rituximab and mycophenolate mofetil but no oral steroids.

Arthritis and rheumatism, 2005-09

Use of a gonadotropin-releasing hormone analog for protection against premature ovarian failure during cyclophosphamide therapy in women with severe lupus.

Arthritis & rheumatology (Hoboken, N.J.), 2015-05

Randomized, double-blind, dose-escalation trial of triptorelin for ovary protection in childhood-onset systemic lupus erythematosus.

Lupus,

Preservation of fertility and ovarian function and minimizing gonadotoxicity in young women with systemic lupus erythematosus treated by chemotherapy.

Best Pract Res Clin Obstet Gynaecol, 2019 Nov 13

Ovarian protection with gonadotropin-releasing hormone agonists during cyclophosphamide therapy in systemic lupus erythematosus.

J. Am. Coll. Cardiol.,

Hydroxychloroquine to Prevent Recurrent Congenital Heart Block in Fetuses of Anti-SSA/Ro-Positive Mothers.

Arthritis and rheumatism, 1982-11

The 1982 revised criteria for the classification of systemic lupus erythematosus.

Arthritis and rheumatism, 2012-08

Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus.

, 2019 Aug 06

2019 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus.

Arthritis Rheum.,

Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus.

Arthritis and rheumatism, 2010-01

Incidence and prevention of bladder toxicity from cyclophosphamide in the treatment of rheumatic diseases: a data-driven review.

J. Rheumatol., 2019 Sep 01

Malignancies in Patients with Antineutrophil Cytoplasmic Antibody-associated Vasculitis: A Population-based Cohort Study.

N Engl J Med,

Two-Year, Randomized, Controlled Trial of Belimumab in Lupus Nephritis.

Southern medical journal, 2016-11

Effects of Statin Therapy in Patients with Systemic Lupus Erythematosus.

Annals of the rheumatic diseases, 2011-05

Lupus Atherosclerosis Prevention Study (LAPS).

Atherosclerosis, 2015 Aug 28

Statin reduces mortality and morbidity in systemic lupus erythematosus patients with hyperlipidemia: A nationwide population-based cohort study.

JAMA ophthalmology, 2014-12

The risk of toxic retinopathy in patients on long-term hydroxychloroquine therapy.

Can J Ophthalmol,

Retinal toxicity of high-dose hydroxychloroquine in patients with chronic graft-versus-host disease.

J Am Acad Dermatol, 2016 Feb 03

The effect of increasing the dose of hydroxychloroquine (HCQ) in patients with refractory cutaneous lupus erythematosus (CLE): An open-label prospective pilot study.

Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, 2008-10

Prophylactic antibiotic usage for Pneumocystis jirovecii pneumonia in patients with systemic lupus erythematosus on cyclophosphamide: a survey of US rheumatologists and the review of literature.

Clin Rheumatol, 2006 Dec 21

Blood, 2015 May 13

A novel triple therapy for ITP using high-dose dexamethasone, low-dose rituximab, and cyclosporine (TT4).

Blood, 2009 Nov 06

Combination immunosuppressant therapy for patients with chronic refractory immune thrombocytopenic purpura.

Annals of the rheumatic diseases, 2011-10

Autoantibodies as biomarkers for the prediction of neuropsychiatric events in systemic lupus erythematosus.

Arthritis Rheum,

Accuracy of anti-ribosomal P protein antibody testing for the diagnosis of neuropsychiatric systemic lupus erythematosus: an international meta-analysis.

Rheumatol Int, 2019 Apr 30

Indications for bone marrow examinations in rheumatology.

Clin Exp Rheumatol, 2012 Sep 25

Indications for bone marrow examination in autoimmune disorders with concurrent haematologic alterations.

Wien Klin Wochenschr,

[Rationale for bone marrow examination in patients with inflammatory rheumatic diseases].

Kidney international, 2019-01

A randomized, controlled double-blind study comparing the efficacy and safety of dose-ranging voclosporin with placebo in achieving remission in patients with active lupus nephritis.

J Rheumatol, 2006 Jul 01

Therapy with granulocyte colony-stimulating factor in systemic lupus erythematosus may be associated with severe flares.

Semin Arthritis Rheum,

Treatment of severe neutropenia due to Felty's syndrome or systemic lupus erythematosus with granulocyte colony-stimulating factor.

Lupus, 2008-08

Rituximab treatment of pulmonary arterial hypertension associated with systemic lupus erythematosus: a case report.

Arthritis Rheumatol, 2021 Aug 12

Predicting the Risk of Pulmonary Arterial Hypertension in Systemic Lupus Erythematosus: A Chinese Systemic Lupus Erythematosus Treatment and Research Group Cohort Study.

Int J Clin Pract, 2021 Mar 24

Effect of COVID-19 medications on corrected QT interval and induction of torsade de pointes: Results of a multicenter national survey.

Mod Rheumatol, 2021 Feb 09

QTc interval prolongation in patients with systemic lupus erythematosus treated with hydroxychloroquine.

Heart Rhythm, 2020 Jun 28

Effects of hydroxychloroquine treatment on QT interval.

Blood,

Adenovirus-induced thrombocytopenia: the role of von Willebrand factor and P-selectin in mediating accelerated platelet clearance.

Arthritis care & research, 2018-03

Examination of Hydroxychloroquine Use and Hemolytic Anemia in G6PDH-Deficient Patients.

J Clin Rheumatol, 2020 Sep 18

Association of Hydroxychloroquine use and Hemolytic Anemia in Patients With Low Levels of Glucose-6-Phosphate Dehydrogenase.

Cureus, 2020 Aug 02

A Study on the Relevance of Glucose-6-Phosphate Dehydrogenase Level Screening in Patients with Rheumatic Diseases Prior to Initiating Treatment With Hydroxychloroquine.

The New England journal of medicine, 2003-10-16

Development of autoantibodies before the clinical onset of systemic lupus erythematosus.

Lupus, 2007

Hydroxychloroquine sulfate treatment is associated with later onset of systemic lupus erythematosus.

J Allergy Clin Immunol, 2020 May 22

Autoantibody-positive healthy individuals with lower lupus risk display a unique immune endotype.

Nat Rev Rheumatol,

Diagnostic role of anti-dsDNA antibodies: do not forget autoimmune hepatitis.

Arthritis & rheumatology (Hoboken, N.J.), 2015-07

Mood Disorders in Systemic Lupus Erythematosus: Results From an International Inception Cohort Study.

Arthritis Rheum,

The American College of Rheumatology nomenclature and case definitions for neuropsychiatric lupus syndromes.

Lancet, 2021 May 07

Efficacy and safety of voclosporin versus placebo for lupus nephritis (AURORA 1): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial.

Autoimmunity reviews, 2009-02

The risk of ultraviolet radiation exposure from indoor lamps in lupus erythematosus.

Arthritis and rheumatism, 2013-07

Vitamin D in systemic lupus erythematosus: modest association with disease activity and the urine protein-to-creatinine ratio.

Arthritis Rheumatol, 2021 Mar 24

Long-Term Safety and Efficacy of Anifrolumab in Adults With Systemic Lupus Erythematosus: Results of a Phase II Open-Label Extension Study.

Rev Med Interne, 2016 Oct 13

[Blood concentration of hydroxychloroquine in systemic lupus erythematosus care: Usefulness and limits].

Arthritis Care Res (Hoboken), 2021 Mar 30

Clinical Significance of Monitoring Hydroxychloroquine Levels in Patients With Systemic Lupus Erythematosus: A Systematic Review and Meta-Analysis.

JAMA Dermatol,

Hydroxychloroquine-induced pigmentation in patients with systemic lupus erythematosus: a case-control study.

Mod Rheumatol, 2020 Sep 17

Anifrolumab, a monoclonal antibody to the type I interferon receptor subunit 1, for the treatment of systemic lupus erythematosus: an overview from clinical trials.

Ann Rheum Dis, 2014 Feb 13

The number of flares patients experience impacts on damage accrual in systemic lupus erythematosus: data from a multiethnic Latin American cohort.

Ann Rheum Dis, 2019 Jan 04

Organ damage in patients treated with belimumab versus standard of care: a propensity score-matched comparative analysis.

Ann Rheum Dis, 2014 Apr 16

Treat-to-target in systemic lupus erythematosus: recommendations from an international task force.

N Engl J Med, 2019 Dec 18

Trial of Anifrolumab in Active Systemic Lupus Erythematosus.

Seminars in arthritis and rheumatism, 2010-12

Psoriatic skin lesions induced by tumor necrosis factor antagonist therapy: clinical features and possible immunopathogenesis.

Clin Exp Rheumatol, 2012 Oct 17

Anti-tumour necrosis factor alpha therapy and increased risk of de novo psoriasis: is it really a paradoxical side effect?

Inflamm Bowel Dis,

Tumor necrosis factor α antagonist-associated psoriasis in inflammatory diseases: an analysis of the FDA adverse event reporting system.

Am J Clin Dermatol,

Tumor necrosis factor-alpha inhibitor-induced psoriasis or psoriasiform exanthemata: first 120 cases from the literature including a series of six new patients.

Journal of the American Society of Nephrology : JASN, 1993-07

Reversible renal failure in the primary antiphospholipid syndrome--a report of two cases.

Arthritis and rheumatism, 2013-02

A pilot open-label phase II trial of rituximab for non-criteria manifestations of antiphospholipid syndrome.

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2014-02

Eculizumab prevents recurrent antiphospholipid antibody syndrome and enables successful renal transplantation.

Lupus, 2018-03

Hydroxychloroquine in the primary thrombosis prophylaxis of antiphospholipid antibody positive patients without systemic autoimmune disease.

Annals of the rheumatic diseases, 2019-10

EULAR recommendations for the management of antiphospholipid syndrome in adults.

Lupus,

16th International Congress on Antiphospholipid Antibodies Task Force Report on Antiphospholipid Syndrome Treatment Trends.

Arthritis Rheum,

Risk factors for thrombosis and primary thrombosis prevention in patients with systemic lupus erythematosus with or without antiphospholipid antibodies.

Rheumatology (Oxford), 2021 May 18

Cognitive dysfunction and associated neuroimaging biomarkers in antiphospholipid syndrome: a systematic review.

Am J Transplant, 2013 Jun 13