Organ damage in Systemic Lupus Erythematosus patients: A multifactorial phenomenon

Ceccarelli, Fulvia; Perricone, Carlo; Natalucci, Francesco; Picciariello, Licia; Olivieri, G.; Cafaro, Giacomo; Bartoloni, Elena; Gerli, Roberto; Conti, Fabrizio

doi:10.1016/j.autrev.2023.103374

Cited by 11 publications

(6 citation statements)

References 81 publications

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“…Finally, from an evolutionary point of view, the study noted a signi cantly greater frequency of infection and progression to chronic kidney disease in patients who had experienced relapses. Indeed, it has been widely demonstrated that a high frequency of relapse is associated with organ damage and progression to end-stage renal disease in patients with lupus nephritis [21]. Moreover, the high frequency of infection is explained by immunosuppression induced by the intensi cation of immunosuppressive therapy instituted at each relapse episode [22].…”

Section: Discussionmentioning

confidence: 99%

Frequency and Factors Associated With Flare-ups in Lupus Patients With Lupus Nephritis in French Guiana

BUNKETE,

FERMIGIER,

SIDIBE

et al. 2024

Preprint

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INTRODUCTION: French Guiana ranks third in terms of the prevalence of systemic lupus erythematosus (SL) in overseas French departments; however, data are insufficient. Lupus flares (LF) are multifactorial and have adverse consequences, particularly in patients with lupus nephritis (LN). This study aimed to determine the factors associated with LF in patients with LN compared with those in patients without LN. METHODS This cross-sectional case-control study of the West Guyanese historical lupus cohort investigated factors associated with lupus flares by comparing two subgroups of lupus patients, namely, those with LN and those without LN, from January 2018 to December 2022. A logistic model helps establish the association between LN and FL. The significance threshold was set at P < 0.05. RESULTS Sixty-two total with 62 patients were included in the study of wich:72.6% with LN and 27.4% with no LNs) were included in the study. The two groups were comparable in terms of size. LF was present in 53% of the patients in both subgroups. LF was found in 62% of the patients in the LN group. High levels of anti-Dna and anti-Smith antibodies, fever, pleurisy, discoid rash, verspetillo, oral ulceration, and a high Sledai score were found more frequently and significantly in patients with relapse. Logistic regression analysis revealed that LN and anti-DNA antibody levels were significantly associated with LF. A higher frequency of infection and CKD progression was observed. Conclusions LF is more frequent and multifactorial in patients with LN and is associated with poor renal prognosis and an increased risk of infection.

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Section: Discussionmentioning

confidence: 99%

Frequency and Factors Associated With Flare-ups in Lupus Patients With Lupus Nephritis in French Guiana

BUNKETE,

FERMIGIER,

SIDIBE

et al. 2024

Preprint

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“…The ISS Guidelines on "Diagnosis, Risk Stratification and Continuity of Care of Fragility Fractures" have rated it at least equivalent to FRAX® and recommend its use (11,15). DeFRA has been found to be more accurate than FRAX®, particularly in postmenopausal women with certain forms of secondary osteoporosis, such as those associated with diabetes (39,40), or systemic lupus erythematosus (41). The use of DeFRA has also been recommended by a Commission of the Superior Council of Health on Orthopedic Pathology in fragile conditions (42) and by the Diagnostic Therapeutic Care Pathways for the prevention of FF in several regions, including Campania, Veneto, and Lombardy.…”

Section: Proposals For Improving the Use Of Anabolics In The Manageme...mentioning

confidence: 99%

Expert opinion on the management of patients with osteoporosis with anabolic drugs in Italy

Rossini,

Cantatore,

Del Puente

et al. 2024

Reumatismo

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Objective. Fragility fractures (FF) resulting from osteoporosis pose a significant public health challenge in Italy, with considerable socio-health and economic implications. Despite the availability of safe and effective drugs, osteoporosis remains underdiagnosed and undertreated, leaving over 2 million high-risk Italian women without treatment. This paper aims to identify and propose key improvements in the management of osteoporosis, focusing particularly on the critical issues related to the use of anabolic drugs in secondary prevention, according to the current Italian Medicines Agency (AIFA) Note 79. Methods. The Expert Panel, composed of nine recognized Italian experts in rheumatology, analyzed current practices, prescribing criteria, and the most recent literature. Three main reasons for revising the indications on pharmacological treatment of osteoporosis were identified: inadequate treatment of osteoporosis, new evidence regarding frontline placement of anabolics in high-risk conditions, and emerging sequential or combined strategies. Results. The proposed improvements include the adoption of the Derived Fracture Risk Assessment algorithm for accurate fracture risk assessment, revision of AIFA Note 79 to reflect current evidence, improved prescribing appropriateness, broader access to anabolic agents, and the provision of sequential therapies with antiresorptives for teriparatide. These changes aim to enhance patient outcomes, streamline healthcare processes, and address the high percentage of undertreated individuals. Conclusions. This expert opinion emphasizes the importance of the appropriate use of anabolic drugs to reduce FF and associated costs while ensuring the sustainability of the National Health Service. The proposed recommendations are in line with the latest scientific evidence, providing a comprehensive strategy to optimize the management of osteoporosis in Italy. On behalf of the Study Group on Osteoporosis and Skeletal Metabolic Diseases of the Italian Society of Rheumatology.

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“…A paradigmatic example is given by systemic lupus erythematosus (SLE) and similar manifestations. This autoimmune disorder (i.e., type III hypersensitivity response) is characterized by the loss of homeostasis of the immune system, which mistakenly attacks healthy tissue leading to the onset of several symptoms, such as painful joint, fever, ulcers, swollen lymph nodes and skin rash ( Ceccarelli et al, 2023 ). Generally, SLE is associated with cardiovascular comorbidities, which represent the first cause of death ( Lisnevskaia et al, 2014 ).…”

Section: Novel Potential Pharmacological Applicationsmentioning

confidence: 99%

Novel potential pharmacological applications of dimethyl fumarate—an overview and update

Bresciani,

Manai,

Davinelli

et al. 2023

Front. Pharmacol.

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Dimethyl fumarate (DMF) is an FDA-approved drug for the treatment of psoriasis and multiple sclerosis. DMF is known to stabilize the transcription factor Nrf2, which in turn induces the expression of antioxidant response element genes. It has also been shown that DMF influences autophagy and participates in the transcriptional control of inflammatory factors by inhibiting NF-κB and its downstream targets. DMF is receiving increasing attention for its potential to be repurposed for several diseases. This versatile molecule is indeed able to exert beneficial effects on different medical conditions through a pleiotropic mechanism, in virtue of its antioxidant, immunomodulatory, neuroprotective, anti-inflammatory, and anti-proliferative effects. A growing number of preclinical and clinical studies show that DMF may have important therapeutic implications for chronic diseases, such as cardiovascular and respiratory pathologies, cancer, eye disorders, neurodegenerative conditions, and systemic or organ specific inflammatory and immune-mediated diseases. This comprehensive review summarizes and highlights the plethora of DMF’s beneficial effects and underlines its repurposing opportunities in a variety of clinical conditions.

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Organ damage in Systemic Lupus Erythematosus patients: A multifactorial phenomenon

Cited by 11 publications

References 81 publications

Frequency and Factors Associated With Flare-ups in Lupus Patients With Lupus Nephritis in French Guiana

Frequency and Factors Associated With Flare-ups in Lupus Patients With Lupus Nephritis in French Guiana

Expert opinion on the management of patients with osteoporosis with anabolic drugs in Italy

Novel potential pharmacological applications of dimethyl fumarate—an overview and update

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