Management of non‐renal manifestations of systemic lupus erythematosus: A systematic literature review for the <scp>APLAR</scp> consensus statements

Kasitanon, Nuntana; Hamijoyo, Laniyati; Li, Mengtao; Oku, Kenji; Navarra, Sandra V.; Tanaka, Yoshiya; Mok, Chi Chiu

doi:10.1111/1756-185x.14413

Cited by 11 publications

(15 citation statements)

References 115 publications

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“…MLK has an acceptable safety profile and a long‐term experience in clinical practice. There is a need for alternatives to treat non‐renal manifestations in SLE among different populations 15 . Repositioning of existing medications is a valuable shortcut to develop novel indications for treatments.…”

Section: Discussionmentioning

confidence: 99%

Montelukast as a treatment for refractory cutaneous lupus: A case series

et al. 2023

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IntroductionThere are no drugs specifically approved to treat cutaneous lupus. Inflammatory cells in lupus skin lesions can produce leukotrienes (LT), which promote tissue damage. In addition to hypersensitivity reactions, LT are also associated with cardiovascular diseases and elevated serum LT levels have been linked to worse atherosclerotic disease in lupus. Targeting LT could thus be an alternative to treat lupus. We present 4 cases of cutaneous lupus successfully treated with montelukast (MLK), a Cys‐LT antagonist.MethodsFour consecutive female systemic lupus erythematosus (SLE) patients with refractory skin lesions were treated with MLK (10 mg/d) in the Hospital Universitário Walter Cantídio of the Universidade Federal do Ceará. Skin lesions were scored using Revised Cutaneous LE Disease Area and Severity Index (RCLASI). Relative expression of the 5‐lipoxigenase (ALOX5) and 15‐lipoxigenase (ALOX15) genes was determined in peripheral blood cells (PBC) from lupus patients and 4 age‐matched female controls.ResultsAll patients experienced improvement of skin lesions measured using RCLASI scores within 2–12 weeks following initiation of MLK. The response was sustained for at least 3 months follow‐up and no adverse events were recorded. ALOX5 but not ALOX15 gene expression was significantly (P = 0.0425) increased in PBC from SLE patients vs controls.ConclusionThis is the first report of a fast and sustained successful response of cutaneous lupus to MLK. Given its acceptable safety profile, our data encourage development of a randomized trial as an attempt to reposition MLK as a safe, affordable alternative to treat cutaneous lupus.

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Section: Discussionmentioning

confidence: 99%

Montelukast as a treatment for refractory cutaneous lupus: A case series

et al. 2023

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“…Table 1 shows the patients’ profiles and laboratory results. Case number 1 had systemic lupus erythematosus (SLE) plus nocardiosis disseminated from skin to lung and intracranial region 2 . Case number 2 had anti‐synthetase syndrome combined with cutaneous nocardiosis 3 .…”

Section: Case Presentationmentioning

confidence: 99%

Nocardiosis in rheumatic patients: Case series and review of literature

Luan

et al. 2023

Int J of Rheum Dis

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Early diagnosis of nocardiosis in patients with rheumatic disease isdifficultbecauseofitsvariedclinicalmanifestationsandtheabsence of known specific biomarkers. However, delayed diagnosis commonlyworsenstheprognosis. 1 Hence,theunderstandingofnocardiosiscombinedwithrheumaticdiseasesisstillinsufficientand inneedofresearch.Inthisarticle,toenhancetheknowledgeofthis disease,weretrospectivelyanalyzedthreepatientswithrheumatic diseasewithnocardiosis,andalsoreviewedrelevantliterature.

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“…Systemic lupus erythematosus (SLE) is a chronic autoimmune disease and involves almost every organ in the body with a broad spectrum of manifestations 1–3 . Neuropsychiatric systemic lupus erythematosus (NPSLE) is one of the severe complications of SLE with increased morbidity and mortality 4 .…”

Section: Introductionmentioning

confidence: 99%

“…Systemic lupus erythematosus (SLE) is a chronic autoimmune disease and involves almost every organ in the body with a broad spectrum of manifestations. [1][2][3] Neuropsychiatric systemic lupus erythematosus (NPSLE) is one of the severe complications of SLE with increased morbidity and mortality. 4 A threefold to tenfold increase in mortality rate is observed in NPSLE compared with SLE without neuropsychiatric events 5 and the general population, 6 respectively.…”

Section: Introductionmentioning

confidence: 99%

Performance of eye sign combined with increased interleukin‐6 in cerebrospinal fluid in patients with neuropsychiatric lupus erythematosus

Shi

Liu

et al. 2023

Int J of Rheum Dis

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Objectives To ascertain whether microvascular alterations of eye sign combined with intrathecal concentrations of interleukin‐6 (IL‐6) can predict the development of neuropsychiatric systemic lupus erythematosus (NPSLE). Methods Cerebrospinal fluid (CSF) and serum samples of IL‐6 were collected and measured at the same time for patients with SLE who were consecutively enrolled. Patients with a diagnosis of NPSLE were identified. Eye sign examinations according to our criteria were performed and scored for all SLE patients. Demographic and clinical parameters were compared between groups to identify potential predictors for NPSLE using multivariable logistic regression analysis. The performance of potential predictors from eye sign along with IL‐6 in the CSF was assessed. Results A total of 120 patients with SLE were enrolled; 30 with NPSLE and 90 with non‐NPSLE. No significant positive correlation was observed between CSF level and serum level of IL‐6. CSF IL‐6 was significant higher in the NPSLE group than the non‐NPSLE (P < 0.001) group. Multivariable logistic analysis revealed that total score, ramified loops, and microangioma of eye sign were predictors for NPSLE after adjusting for SLE Disease Activity Index (SLEDAI) and antiphospholipid antibody (APL). Total score, ramified loops, microangioma of eye sign, and SLEDAI remain significant predictors for NPSLE after adjusting for CSF IL‐6. Using receiver operating characteristics curve analysis, the cut‐off point of potential predictors was applied in multivariable logistic analysis; APL, total score, ramified loops, and microangioma of eye sign remain significant predictors for NPSLE after adjusting for CSF IL‐6. Conclusion Specific microvascular alterations of eye sign are predictors for the development of NPSLE in addition to increased IL‐6 in the CSF.

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Management of non‐renal manifestations of systemic lupus erythematosus: A systematic literature review for the APLAR consensus statements

Cited by 11 publications

References 115 publications

Montelukast as a treatment for refractory cutaneous lupus: A case series

Montelukast as a treatment for refractory cutaneous lupus: A case series

Nocardiosis in rheumatic patients: Case series and review of literature

Performance of eye sign combined with increased interleukin‐6 in cerebrospinal fluid in patients with neuropsychiatric lupus erythematosus

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