The management of lupus in young people

McGill, George; Ambrose, Nicola

doi:10.3399/bjgp18x694805

Cited by 5 publications

(6 citation statements)

References 5 publications

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“…Glucocorticoids are the backbone of JSLE therapy, with other DMARDs including hydroxychloroquine, aziothioprine, sulfasalazine, mycophenolate mofetil, and cyclophosphamide. For many young women, whose are diagnosed pre or peri-pubertal, these drugs have life-changing side-effects such as increasing the risk of osteoporosis, increasing the risk in infertility problems and changes in weight gain (52, 53). These side effects, coupled with the increased in mortality rates and severity of disease, demonstrate a clinically unmet need for therapeutics that substantially improve both quality of life and reduce mortality in pediatric patients.…”

Section: Juvenile Systemic Lupus Erythematosusmentioning

confidence: 99%

B Cells as a Therapeutic Target in Paediatric Rheumatic Disease

Wilkinson

Rosser

2019

Front. Immunol.

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B cells carry out a central role in the pathogenesis of autoimmune disease. In addition to the production of autoantibodies, B cells can contribute to disease development by presenting autoantigens to autoreactive T cells and by secreting pro-inflammatory cytokines and chemokines which leads to the amplification of the inflammatory response. Targeting both the antibody-dependent and antibody-independent function of B cells in adult rheumatic disease has led to the advent of B cell targeted therapies in clinical practice. To date, whether B cell depletion could also be utilized for the treatment of pediatric disease is relatively under explored. In this review, we will discuss the role of B cells in the pathogenesis of the pediatric rheumatic diseases Juvenile Idiopathic Arthritis (JIA), Juvenile Systemic Lupus Erythematosus (JSLE) and Juvenile Dermatomyositis (JDM). We will also explore the rationale behind the use of B cell-targeted therapies in pediatric rheumatic disease by highlighting new case studies that points to their efficacy in JIA, JSLE, and JDM.

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Section: Juvenile Systemic Lupus Erythematosusmentioning

confidence: 99%

B Cells as a Therapeutic Target in Paediatric Rheumatic Disease

Wilkinson

Rosser

2019

Front. Immunol.

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“…Eleven studies used a quantitative design, seven a qualitative design, and one study followed a mixed-methods approach, as represented in Table 2. The studies were conducted across nine countries: the United States of America (11), Brazil (1), Columbia (1), China (1), Italy (1), the United Kingdom (1), Singapore (1), Australia (1), and Turkey (1). The included studies had MMAT scores ranging from four to five, with the included in the review that involved more than 1400 CYP ranging in age from eight to twenty-four years of age [36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54]; see Table 2 for Characteristics of Included Studies.…”

Section: Resultsmentioning

confidence: 99%

“…Eleven studies used a quantitative design, seven a qualitative design, and one study followed a mixed-methods approach, as represented in Table 2. The studies were conducted across nine countries: the United States of America (11), Brazil (1), Columbia (1), China (1), Italy (1), the United Kingdom (1), Singapore (1), Australia (1), and Turkey (1). The included studies had MMAT scores ranging from four to five, with the Harry et al ( 2019) study receiving the lowest score of two (Supplementary Table S2 Mixed Methods Appraisal Tool combined results).…”

Section: Resultsmentioning

confidence: 99%

“…Incidences of cSLE are reported as between 0.36 and 2.5 per 100,000 children, with prevalence ranging from 1.89 to 34.1 per 100,000 [ 4 , 5 , 6 , 7 ]. Similar to adult onset (aSLE), cSLE is clinically complex, heterogeneous, and characterized by periods of flare and remission [ 8 ]; however, cSLE is much more aggressive than aSLE with higher disease activity, more severe organ manifestations, and subsequently increased medication burden [ 9 , 10 , 11 ]. Childhood-onset systemic lupus erythematosus most commonly affects the skin (including malar and discoid rash), muscles, and joints; however, involvement of major organs is common, with renal inflammation occurring most frequently [ 2 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Experiences and Perspectives of Children and Young People Living with Childhood-Onset Systemic Lupus Erythematosus—An Integrative Review

et al. 2023

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Childhood-onset systemic lupus erythematosus (cSLE) impacts the daily life of children and young people. This study aimed to describe the experiences and perspectives of children and young people living with cSLE. An integrative review guided by Whittemore and Knafl was conducted. Extant empirical research published in peer-reviewed journals from 2000 to 2021 on children’s self-reported experiences living with cSLE was identified from Scopus, CINAHL, Medline via PubMed, and PsycINFO via Ovid databases. Nineteen studies involving over 1400 participants were included. Four themes and fourteen sub-themes were identified: (1) challenging symptoms (disruptions to life and altered self, severity, fatigue, depression, and anxiety), (2) medicines and side effects (dreaded steroids, conflicting feelings, and medication adherence), (3) complicated life (school sports and social, giving things up, lack of understanding, and quality of life) and (4) ways of coping (family and friends, relationships with health providers, and maintaining positivity). While cSLE shares many similarities with adult-onset SLE, awareness of differences in experiences and perceptions of children and young people is crucial. The significant psychological and social impact of the disease and its treatments necessitates a comprehensive, holistic approach to managing cSLE that considers the unique needs of youth.

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“…Os óbitos nessa faixa etária representaram (17,10%) das mortes ocorridas em Vitória, entretanto este dado constitui uma soma entre indivíduos residentes e não residentes no município. O LES com início juvenil (11 a 18 anos) tende a ter uma forma mais agressiva, altas taxas de envolvimento de órgãos e aumento da necessidade de medicamentos imunossupressores a longo prazo; isso provavelmente causa um maior risco de danos acumulativos e, por consequência, morbidade e mortalidade precoces no grupo de início juvenil (Amaral, Murphy, Ioannou, & Isenberg, 2014;Mcgill & Ambrose, 2018).…”

Section: Discussionunclassified

Perfil epidemiológico de pacientes com lúpus eritematoso sistêmico na cidade de Vitória - Espírito Santo

Soares

Guerrieri

Pancoto

2023

Braz. J. Prod. Eng.

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O Lúpus Eritematoso Sistêmico (LES) é uma doença crônica de caráter autoimune caracterizada por períodos de remissão e recidiva. Os pacientes com LES sofrem de um curso de doença crônica sobrecarregado com comorbidades em múltiplos órgãos. Estudos epidemiológicos sobre LES são muito escassos no Brasil, principalmente no estado do Espírito Santo. Tendo em vista essa escassez de dados epidemiológicos o presente estudo realizou uma pesquisa epidemiológica em pacientes com LES, caracterizando as causas de mortalidade no município de Vitória entre 2009 e 2019, utilizando o banco de dados DATASUS. De acordo com a análise dos óbitos de pacientes com LES ocorridos em Vitória (n=269), as principais causas básicas de morte foram as doenças sistema osteomuscular e tecido conjuntivo, doenças infecciosas e parasitárias, doenças do aparelho respiratório, doenças do sistema circulatório e doenças do aparelho geniturinário, que juntas representaram 84,39% dos registros de óbitos. O sexo feminino apresentou maior número de óbitos em comparação aos com homens, os resultados foram significativos para mulheres de etnia parda e branca, com idade entre 10-49 anos, além disso, essa faixa etária apresentou o maior número de mortes ocorridas em Vitória. Dos 269 óbitos registrados, 182 são de pacientes que não residem em Vitória, o que mostra que muitas cidades capixabas ainda não possuem especialistas para este tipo de atendimento e faltam serviços de saúde mais complexos para atendê-los nas cidades do interior do Espírito Santo.

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The management of lupus in young people

Cited by 5 publications

References 5 publications

B Cells as a Therapeutic Target in Paediatric Rheumatic Disease

B Cells as a Therapeutic Target in Paediatric Rheumatic Disease

Experiences and Perspectives of Children and Young People Living with Childhood-Onset Systemic Lupus Erythematosus—An Integrative Review

Perfil epidemiológico de pacientes com lúpus eritematoso sistêmico na cidade de Vitória - Espírito Santo

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