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1. Does the Use of Immunosuppressive Drugs Impact on SARS-CoV-2 Infection Outcome? Data From A National Cohort of Patients With Immune-Mediated Inflammatory Diseases (SAR-COVID Registry)

Author

Isnardi, Carolina Ayelen, Soriano, Enrique R, Graf, Cesar, de la Vega, María Celina, Pons-Estel, Bernardo A, Roberts, Karen, Quintana, Rosana, Gomez, Gimena, Yazdany, Jinoos, Saurit, Verónica, Báez, Roberto Miguel, Coello, Vanessa Viviana Castro, Pisoni, Cecilia Nora, Berbotto, Guillermo, Vivero, Florencia, Zelaya, Marcos David, Salinas, María J Haye, Torres, Álvaro A Reyes, Ornella, Sofía, Nieto, Romina Estefanía, Maldonado, Federico Nicolás, Gamba, María Julieta, de los Ángeles Severina, María, Tissera, Yohana, Alba, Paula, Cogo, Adriana Karina, Alle, Gelsomina, Gobbi, Carla, Baños, Andrea, Velozo, Edson, Pera, Mariana, Tanten, Romina, Albiero, Juan Alejandro, Ficco, Hernán Maldonado, Martire, María Victoria, Elkin, María Soledad Gálvez, Cosatti, Micaela, Cusa, María Alejandra, Pereira, Dora, Savio, Verónica G, and Pons-Estel, Guillermo J

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Arthritis, Clinical Research, Autoimmune Disease, Lung, Infectious Diseases, Inflammatory and immune system, Good Health and Well Being, Adult, Humans, COVID-19, SARS-CoV-2, Immunomodulating Agents, Arthritis, Rheumatoid, Immunosuppressive Agents, Registries, rheumatic diseases, Argentina, Arthritis & Rheumatology, Clinical sciences
Abstract

Background/objectiveThis study describes the impact of immunomodulatory and/or immunosuppressive (IM/IS) drugs in the outcomes of COVID-19 infection in a cohort of patients with immune-mediated inflammatory diseases (IMIDs).MethodsAdult patients with IMIDs with a confirmed SARS-CoV-2 infection were included. Data were reported by the treating physician between August 13, 2020 and July 31, 2021. Sociodemographic data, comorbidities, and DMARDs, as well as clinical characteristics, complications, and treatment of the SARS-CoV-2 infection, were recorded. Descriptive analysis and multivariable logistic regression models were carried out.ResultsA total of 1672 patients with IMIDs were included, of whom 1402 were treated with IM/IS drugs. The most frequent diseases were rheumatoid arthritis (47.7%) and systemic lupus erythematosus (18.4%). COVID-19 symptoms were present in 95.2% of the patients. A total of 461 (27.6%) patients were hospitalized, 8.2% were admitted to the intensive care unit, and 4.4% died due to COVID-19.Patients without IM/IS treatment used glucocorticoids less frequently but at higher doses, had higher levels of disease activity, were significantly older, were more frequently hospitalized, admitted to the intensive care unit, and died due to COVID-19. After adjusting for these factors, treatment with IM/IS drugs was not associated with a worse COVID-19 outcome (World Health Organization-Ordinal Scale ≥5) (odds ratio, 1.24; 95% confidence interval, 0.73-2.06).ConclusionsSAR-COVID is the first multicenter Argentine registry collecting data from patients with rheumatic diseases and SARS-CoV-2 infection. After adjusting for relevant covariates, treatment with IM/IS drugs was not associated with severe COVID-19 in patients with IMIDs.Study registrationThis study has been registered in ClinicalTrials.gov under the number NCT04568421.

Published
2023

2. Remission and low disease activity (LDA) prevent damage accrual in patients with systemic lupus erythematosus: results from the Systemic Lupus International Collaborating Clinics (SLICC) inception cohort.

Author

Ugarte-Gil, Manuel, Hanly, John, Urowitz, Murray, Gordon, Caroline, Bae, Sang-Cheol, Romero-Diaz, Juanita, Sanchez-Guerrero, Jorge, Bernatsky, Sasha, Clarke, Ann, Wallace, Daniel, Isenberg, David, Rahman, Anisur, Merrill, Joan, Fortin, Paul, Gladman, Dafna, Bruce, Ian, Petri, Michelle, Ginzler, Ellen, Dooley, Mary, Ramsey-Goldman, Rosalind, Manzi, Susan, Jönsen, Andreas, van Vollenhoven, Ronald, Aranow, Cynthia, Mackay, Meggan, Ruiz-Irastorza, Guillermo, Lim, Sam, Inanc, Murat, Jacobsen, Søren, Peschken, Christine, Kamen, Diane, Askanase, Anca, Pons-Estel, Bernardo, Alarcón, Graciela, and Kalunian, Kenneth

Subjects
epidemiology, outcome assessment, health care, systemic lupus erythematosus, Antimalarials, Disease Progression, Female, Humans, Immunosuppressive Agents, Lupus Erythematosus, Systemic, Male, Prednisone, Remission Induction, Severity of Illness Index
Abstract

OBJECTIVE: To determine the independent impact of different definitions of remission and low disease activity (LDA) on damage accrual. METHODS: Patients with ≥2 annual assessments from a longitudinal multinational inception lupus cohort were studied. Five mutually exclusive disease activity states were defined: remission off-treatment: clinical Systemic Lupus Erythematosus Disease Activity Index (cSLEDAI)-2K=0, without prednisone or immunosuppressants; remission on-treatment: cSLEDAI-2K score=0, prednisone ≤5 mg/day and/or maintenance immunosuppressants; low disease activity Toronto cohort (LDA-TC): cSLEDAI-2K score of ≤2, without prednisone or immunosuppressants; modified lupus low disease activity (mLLDAS): Systemic Lupus Erythematosus Disease Activity Index-2K score of 4 with no activity in major organ/systems, no new disease activity, prednisone ≤7.5 mg/day and/or maintenance immunosuppressants; active: all remaining visits. Only the most stringent definition was used per visit. Antimalarials were allowed in all. The proportion of time that patients were in a specific state at each visit since cohort entry was determined. Damage accrual was ascertained with the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI). Univariable and multivariable generalised estimated equation negative binomial regression models were used. Time-dependent covariates were determined at the same annual visit as the disease activity state but the SDI at the subsequent visit. RESULTS: There were 1652 patients, 1464 (88.6%) female, mean age at diagnosis 34.2 (SD 13.4) years and mean follow-up time of 7.7 (SD 4.8) years. Being in remission off-treatment, remission on-treatment, LDA-TC and mLLDAS (per 25% increase) were each associated with a lower probability of damage accrual (remission off-treatment: incidence rate ratio (IRR)=0.75, 95% CI 0.70 to 0.81; remission on-treatment: IRR=0.68, 95% CI 0.62 to 0.75; LDA: IRR=0.79, 95% CI 0.68 to 0.92; and mLLDAS: IRR=0.76, 95% CI 0.65 to 0.89)). CONCLUSIONS: Remission on-treatment and off-treatment, LDA-TC and mLLDAS were associated with less damage accrual, even adjusting for possible confounders and effect modifiers.

Published
2022

3. Factors predictive of severe thrombocytopenia and its impact on poor outcomes in Latin American patients with systemic lupus erythematosus: Data from a multiethnic Latin American cohort

Author

González, Luis Alonso, Harvey, Guillermina B., Quintana, Rosana, Pons-Estel, Guillermo J., Ugarte-Gil, Manuel F., Vásquez, Gloria, Catoggio, Luis J, García, Mercedes A., Borba, Eduardo F., Da Silva, Nilzio A., Brenol, João C. Tavares, Toledano, Marlene Guibert, Massardo, Loreto, Neira, Oscar, Pascual-Ramos, Virginia, Amigo, Mary-Carmen, Barile-Fabris, Leonor A., Torre, Ignacio García De La, Alfaro-Lozano, José, Segami, María I., Chacón-Díaz, Rosa, Esteva-Spinetti, María H., Iglesias-Gamarra, Antonio, Alarcón, Graciela S., and Pons-Estel, Bernardo A.

Published
2024
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4. Impact of glucocorticoids on the incidence of lupus-related major organ damage: a systematic literature review and meta-regression analysis of longitudinal observational studies

Author

Ugarte-Gil, Manuel Francisco, Mak, Anselm, Leong, Joanna, Dharmadhikari, Bhushan, Kow, Nien Yee, Reátegui-Sokolova, Cristina, Elera-Fitzcarrald, Claudia, Aranow, Cinthia, Arnaud, Laurent, Askanase, Anca D, Bae, Sang-Cheol, Bernatsky, Sasha, Bruce, Ian N, Buyon, Jill, Costedoat-Chalumeau, Nathalie, Dooley, Mary Ann, Fortin, Paul R, Ginzler, Ellen M, Gladman, Dafna D, Hanly, John, Inanc, Murat, Isenberg, David, Jacobsen, Soren, James, Judith A, Jönsen, Andreas, Kalunian, Kenneth, Kamen, Diane L, Lim, Sung Sam, Morand, Eric, Mosca, Marta, Peschken, Christine, Pons-Estel, Bernardo A, Rahman, Anisur, Ramsey-Goldman, Rosalind, Reynolds, John, Romero-Diaz, Juanita, Ruiz-Irastorza, Guillermo, Sánchez-Guerrero, Jorge, Svenungsson, Elisabet, Urowitz, Murray, Vinet, Evelyne, van Vollenhoven, Ronald F, Voskuyl, Alexandre, Wallace, Daniel J, Petri, Michelle A, Manzi, Susan, Clarke, Ann Elaine, Cheung, Mike, Farewell, Vernon, and Alarcon, Graciela S

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Autoimmune Disease, Lupus, 6.1 Pharmaceuticals, Evaluation of treatments and therapeutic interventions, Inflammatory and immune system, Female, Glucocorticoids, Humans, Incidence, Longitudinal Studies, Lupus Erythematosus, Systemic, Observational Studies as Topic, Regression Analysis, glucocorticoids, outcome assessment, health care, lupus erythematosus, systemic, Clinical sciences, Immunology
Abstract

In systemic lupus erythematosus (SLE), disease activity and glucocorticoid (GC) exposure are known to contribute to irreversible organ damage. We aimed to examine the association between GC exposure and organ damage occurrence. We conducted a literature search (PubMed (Medline), Embase and Cochrane January 1966-October 2021). We identified original longitudinal observational studies reporting GC exposure as the proportion of users and/or GC use with dose information as well as the occurrence of new major organ damage as defined in the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index. Meta-regression analyses were performed. Reviews, case-reports and studies with

Published
2021

6. Sociodemographic and clinical factors associated with poor COVID-19 outcomes in patients with rheumatic diseases: data from the SAR-COVID Registry

Author

Isnardi, Carolina A., Roberts, Karen, Saurit, Verónica, Petkovic, Ingrid, Báez, Roberto M., Quintana, Rosana, Tissera, Yohana, Ornella, Sofía, D.Angelo Exeni, Maria Eugenia, Pisoni, Cecilia N., Castro Coello, Vanessa V., Berbotto, Guillermo, Haye Salinas, María J., Velozo, Edson, Reyes Torres, Álvaro A., Tanten, Romina, Zelaya, Marcos D., Gobbi, Carla, Alonso, Carla G., de los Ángeles Severina, María, Vivero, Florencia, Paula, Alba, Cogo, Adriana K., Alle, Gelsomina, Pera, Mariana, Nieto, Romina E., Cosatti, Micaela, Asnal, Cecilia, Pereira, Dora, Albiero, Juan A., Savio, Verónica G., Maldonado, Federico N., Gamba, María Julieta, Germán, Noelia F., Baños, Andrea, Gallino Yanzi, Josefina, Gálvez Elkin, María Soledad, Morbiducci, Julieta S., Martire, María Victoria, Maldonado Ficco, Hernán, Schmid, Maria Marcela, Villafañe Torres, Jaime A., de los Ángeles Correa, Maria, Medina, María Alejandra, Cusa, María Alejandra, Scafati, Julia, Agüero, Santiago E., Lloves Schenone, Nicolás M., Soriano, Enrique R., Graf, Cesar, Pons-Estel, Bernardo A., Gomez, Gimena, Landi, Margarita, De la Vega, María Celina, and Pons-Estel, Guillermo J.

Published
2023
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8. Physician Global Assessment International Standardisation COnsensus in Systemic Lupus Erythematosus: the PISCOS study

Author

Appenzeller, Simone, Aranow, Cynthia, Askanase, Anca, Avcin, Tadej, Bae, Sang-Cheol, Bertsias, George, Bonfa, Eloisa, Cairoli, Ernesto, Cardiel, Mario H, Cervera, Ricard, Chasset, François, Chizzolini, Carlo, Clarke, Ann E, Conti, Fabrizio, Costedoat-Chalumeau, Nathalie, Czirják, László, Doria, Andrea, Dörner, Thomas, Espinosa, Gerard, Fischer-Betz, Rebecca, Garcìa, Mercedes, Gladman, Dafna D, González, Luis A, Gunnarsson, Iva, Hamijoyo, Laniyati, Hanly, John G, Hasni, Sarfaraz A, Houssiau, Frédéric A, Inanç, Murat, Inês, Luís S, Isenberg, David, Jacobsen, Soren, Jan Wu, Yeong-Jian, Kaneko, Yuko, Katsumata, Yasuhiro, Lau, Chak S, Legge, Alexandra C, Lerang, Karoline, Limper, Maarten, Louthrenoo, Worawit, Luo, Shue-Fen, Marinho, António, Massardo, Loreto, Mathian, Alexis, Mosca, Marta, Nikpour, Mandana, Pego-Reigosa, José M, Peschken, Christine A, Pons-Estel, Bernardo A, Pons-Estel, Guillermo J, Rahman, Anisur, Rednic, Simona, Ribi, Camillo, Ruiz-Irastorza, Guillermo, Sato, Emilia I, Saxena, Amit, Schneider, Matthias, Sebastiani, Gian Domenico, Strand, Vibeke, Svenungsson, Elisabet, Tanaka, Yoshiya, Tazi Mezalek, Zoubida, Tee, Michael L, Tincani, Angela, Touma, Zahi, Troldborg, Anne, Vasconcelos, Carlos, Vinet, Évelyne, Vital, Edward M, Voskuyl, Alexandre E, Voss, Anne, Wallace, Daniel, Ward, Michael, Zamora, Leonid D, Piga, Matteo, Chessa, Elisabetta, Morand, Eric F, Ugarte-Gil, Manuel F, Tektonidou, Maria, van Vollenhoven, Ronald, Petri, Michelle, and Arnaud, Laurent

Published
2022
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9. Evaluating the Construct of Damage in Systemic Lupus Erythematosus

Author

Johnson, Sindhu R., Gladman, Dafna D., Brunner, Hermine I., Isenberg, David, Clarke, Ann E., Barber, Megan R. W., Arnaud, Laurent, Fortin, Paul R., Mosca, Marta, Voskuyl, Alexandre E., Manzi, Susan, Aranow, Cynthia, Askanase, Anca, Alarcón, Graciela S., Bae, Sang‐Cheol, Costedoat‐Chalumeau, Nathalie, English, Jessica A., Pons‐Estel, Guillermo J., Pons‐Estel, Bernardo A., Gilman, Rebecca, Ginzler, Ellen M., Hanly, John G., Jacobsen, Soren, Kalunian, Kenneth, Kamen, Diane L., Lambalgen, Chynace, Legge, Alexandra, Lim, S. Sam, Mak, Anselm, Morand, Eric F., Peschken, Christine A., Petri, Michelle, Rahman, Anisur, Ramsey‐Goldman, Rosalind, Reynolds, John A., Romero‐Diaz, Juanita, Ruiz‐Irastorza, Guillermo, Sanchez‐Guerrero, Jorge, Svenungsson, Elisabet, Touma, Zahi, Urowitz, Murray, Vinet, Evelyne, van Vollenhoven, Ronald F., Waldhauser, Heather, Wallace, Daniel J., Zoma, Asad, and Bruce, Ian N.

Published
2023
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11. Genetic contributions to lupus nephritis in a multi-ethnic cohort of systemic lupus erythematous patients

Author

Lanata, Cristina M, Nititham, Joanne, Taylor, Kimberly E, Chung, Sharon A, Torgerson, Dara G, Seldin, Michael F, Pons-Estel, Bernardo A, Tusié-Luna, Teresa, Tsao, Betty P, Morand, Eric F, Alarcón-Riquelme, Marta E, and Criswell, Lindsey A

Subjects
Biological Sciences, Biomedical and Clinical Sciences, Genetics, Epidemiology, Health Sciences, Lupus, Clinical Research, Human Genome, Autoimmune Disease, Kidney Disease, Aetiology, 2.1 Biological and endogenous factors, Inflammatory and immune system, Adult, Cohort Studies, Female, Humans, Lupus Nephritis, Male, Middle Aged, Models, Genetic, Polymorphism, Single Nucleotide, Risk Factors, General Science & Technology
Abstract

ObjectiveAfrican Americans, East Asians, and Hispanics with systemic lupus erythematous (SLE) are more likely to develop lupus nephritis (LN) than are SLE patients of European descent. The etiology of this difference is not clear, and this study was undertaken to investigate how genetic variants might explain this effect.MethodsIn this cross-sectional study, 1244 SLE patients from multiethnic case collections were genotyped for 817,810 single-nucleotide polymorphisms (SNPs) across the genome. Continental genetic ancestry was estimated utilizing the program ADMIXTURE. Gene-based testing and pathway analysis was performed within each ethnic group and meta-analyzed across ethnicities. We also performed candidate SNP association tests with SNPs previously established as risk alleles for SLE, LN, and chronic kidney disease (CKD). Association testing and logistic regression models were performed with LN as the outcome, adjusted for continental ancestries, sex, disease duration, and age.ResultsWe studied 255 North European, 263 South European, 238 Hispanic, 224 African American and 264 East Asian SLE patients, of whom 606 had LN (48.7%). In genome-wide gene-based and candidate SNP analyses, we found distinct genes, pathways and established risk SNPs associated with LN for each ethnic group. Gene-based analyses showed significant associations between variation in ZNF546 (p = 1.0E-06), TRIM15 (p = 1.0E-06), and TRIMI0 (p = 1.0E-06) and LN among South Europeans, and TTC34 (p = 8.0E-06) was significantly associated with LN among Hispanics. The SNP rs8091180 in NFATC1 was associated with LN (OR 1.43, p = 3.3E-04) in the candidate SNP meta-analysis with the highest OR among African-Americans (OR 2.17, p = 0.0035).ConclusionDistinct genetic factors are associated with the risk of LN in SLE patients of different ethnicities. CKD risk alleles may play a role in the development of LN in addition to SLE-associated risk variants. These findings may further explain the clinical heterogeneity of LN risk and response to therapy observed between different ethnic groups.

Published
2018

16. Transancestral mapping and genetic load in systemic lupus erythematosus.

Author

Langefeld, Carl D, Ainsworth, Hannah C, Cunninghame Graham, Deborah S, Kelly, Jennifer A, Comeau, Mary E, Marion, Miranda C, Howard, Timothy D, Ramos, Paula S, Croker, Jennifer A, Morris, David L, Sandling, Johanna K, Almlöf, Jonas Carlsson, Acevedo-Vásquez, Eduardo M, Alarcón, Graciela S, Babini, Alejandra M, Baca, Vicente, Bengtsson, Anders A, Berbotto, Guillermo A, Bijl, Marc, Brown, Elizabeth E, Brunner, Hermine I, Cardiel, Mario H, Catoggio, Luis, Cervera, Ricard, Cucho-Venegas, Jorge M, Dahlqvist, Solbritt Rantapää, D'Alfonso, Sandra, Da Silva, Berta Martins, de la Rúa Figueroa, Iñigo, Doria, Andrea, Edberg, Jeffrey C, Endreffy, Emőke, Esquivel-Valerio, Jorge A, Fortin, Paul R, Freedman, Barry I, Frostegård, Johan, García, Mercedes A, de la Torre, Ignacio García, Gilkeson, Gary S, Gladman, Dafna D, Gunnarsson, Iva, Guthridge, Joel M, Huggins, Jennifer L, James, Judith A, Kallenberg, Cees GM, Kamen, Diane L, Karp, David R, Kaufman, Kenneth M, Kottyan, Leah C, Kovács, László, Laustrup, Helle, Lauwerys, Bernard R, Li, Quan-Zhen, Maradiaga-Ceceña, Marco A, Martín, Javier, McCune, Joseph M, McWilliams, David R, Merrill, Joan T, Miranda, Pedro, Moctezuma, José F, Nath, Swapan K, Niewold, Timothy B, Orozco, Lorena, Ortego-Centeno, Norberto, Petri, Michelle, Pineau, Christian A, Pons-Estel, Bernardo A, Pope, Janet, Raj, Prithvi, Ramsey-Goldman, Rosalind, Reveille, John D, Russell, Laurie P, Sabio, José M, Aguilar-Salinas, Carlos A, Scherbarth, Hugo R, Scorza, Raffaella, Seldin, Michael F, Sjöwall, Christopher, Svenungsson, Elisabet, Thompson, Susan D, Toloza, Sergio MA, Truedsson, Lennart, Tusié-Luna, Teresa, Vasconcelos, Carlos, Vilá, Luis M, Wallace, Daniel J, Weisman, Michael H, Wither, Joan E, Bhangale, Tushar, Oksenberg, Jorge R, Rioux, John D, Gregersen, Peter K, Syvänen, Ann-Christine, Rönnblom, Lars, Criswell, Lindsey A, Jacob, Chaim O, Sivils, Kathy L, Tsao, Betty P, Schanberg, Laura E, and Behrens, Timothy W

Subjects
Humans, Lupus Erythematosus, Systemic, HLA Antigens, Logistic Models, Case-Control Studies, Mutagenesis, Insertional, Age of Onset, Sequence Deletion, Genetic Load, Multifactorial Inheritance, Polymorphism, Single Nucleotide, African Continental Ancestry Group, American Native Continental Ancestry Group, European Continental Ancestry Group, Hispanic Americans, Lupus Erythematosus, Systemic, Mutagenesis, Insertional, Polymorphism, Single Nucleotide
Abstract

Systemic lupus erythematosus (SLE) is an autoimmune disease with marked gender and ethnic disparities. We report a large transancestral association study of SLE using Immunochip genotype data from 27,574 individuals of European (EA), African (AA) and Hispanic Amerindian (HA) ancestry. We identify 58 distinct non-HLA regions in EA, 9 in AA and 16 in HA (∼50% of these regions have multiple independent associations); these include 24 novel SLE regions (P

Published
2017

18. EULAR recommendations for the management of systemic lupus erythematosus : 2023 update

Author

Fanouriakis, Antonis, Kostopoulou, Myrto, Andersen, Jeanette, Aringer, Martin, Arnaud, Laurent, Bae, Sang-Cheol, Boletis, John, Bruce, Ian N., Cervera, Ricard, Doria, Andrea, Dörner, Thomas, Furie, Richard A., Gladman, Dafna D., Houssiau, Frederic A., Inês, Luís Sousa, Jayne, David, Kouloumas, Marios, Kovács, László, Mok, Chi Chiu, Morand, Eric F., Moroni, Gabriella, Mosca, Marta, Mucke, Johanna, Mukhtyar, Chetan B., Nagy, György, Navarra, Sandra, Parodis, Ioannis, Pego-Reigosa, José M., Petri, Michelle, Pons-Estel, Bernardo A., Schneider, Matthias, Smolen, Josef S., Svenungsson, Elisabet, Tanaka, Yoshiya, Tektonidou, Maria G., Teng, Yk Onno, Tincani, Angela, Vital, Edward M., van Vollenhoven, Ronald F., Wincup, Chris, Bertsias, George, Boumpas, Dimitrios T., Fanouriakis, Antonis, Kostopoulou, Myrto, Andersen, Jeanette, Aringer, Martin, Arnaud, Laurent, Bae, Sang-Cheol, Boletis, John, Bruce, Ian N., Cervera, Ricard, Doria, Andrea, Dörner, Thomas, Furie, Richard A., Gladman, Dafna D., Houssiau, Frederic A., Inês, Luís Sousa, Jayne, David, Kouloumas, Marios, Kovács, László, Mok, Chi Chiu, Morand, Eric F., Moroni, Gabriella, Mosca, Marta, Mucke, Johanna, Mukhtyar, Chetan B., Nagy, György, Navarra, Sandra, Parodis, Ioannis, Pego-Reigosa, José M., Petri, Michelle, Pons-Estel, Bernardo A., Schneider, Matthias, Smolen, Josef S., Svenungsson, Elisabet, Tanaka, Yoshiya, Tektonidou, Maria G., Teng, Yk Onno, Tincani, Angela, Vital, Edward M., van Vollenhoven, Ronald F., Wincup, Chris, Bertsias, George, and Boumpas, Dimitrios T.

Abstract

OBJECTIVES: To update the EULAR recommendations for the management of systemic lupus erythematosus (SLE) based on emerging new evidence. METHODS: An international Task Force formed the questions for the systematic literature reviews (January 2018-December 2022), followed by formulation and finalisation of the statements after a series of meetings. A predefined voting process was applied to each overarching principle and recommendation. Levels of evidence and strengths of recommendation were assigned, and participants finally provided their level of agreement with each item. RESULTS: The Task Force agreed on 5 overarching principles and 13 recommendations, concerning the use of hydroxychloroquine (HCQ), glucocorticoids (GC), immunosuppressive drugs (ISDs) (including methotrexate, mycophenolate, azathioprine, cyclophosphamide (CYC)), calcineurin inhibitors (CNIs, cyclosporine, tacrolimus, voclosporin) and biologics (belimumab, anifrolumab, rituximab). Advice is also provided on treatment strategies and targets of therapy, assessment of response, combination and sequential therapies, and tapering of therapy. HCQ is recommended for all patients with lupus at a target dose 5 mg/kg real body weight/day, considering the individual's risk for flares and retinal toxicity. GC are used as 'bridging therapy' during periods of disease activity; for maintenance treatment, they should be minimised to equal or less than 5 mg/day (prednisone equivalent) and, when possible, withdrawn. Prompt initiation of ISDs (methotrexate, azathioprine, mycophenolate) and/or biological agents (anifrolumab, belimumab) should be considered to control the disease and facilitate GC tapering/discontinuation. CYC and rituximab should be considered in organ-threatening and refractory disease, respectively. For active lupus nephritis, GC, mycophenolate or low-dose intravenous CYC are recommended as anchor drugs, and add-on therapy with belimumab or CNIs (voclosporin or tacrolimus) should be considered. Upd

Published
2024
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19. Tocilizumab in systemic sclerosis: a randomised, double-blind, placebo-controlled, phase 3 trial

Author

Lucero, Eleonora, Pons-Estel, Bernardo, Rivero, Mariano, Tate, Guillermo, Smith, Vanessa, De Langhe, Ellen, Rashkov, Rasho, Batalov, Anastas, Goranov, Ivan, Stoilov, Rumen, Dunne, James, Johnson, Sindhu R., Pope, Janet E., Martinović Kaliterna, Dušanka, Mogensen, Mette, Olesen, Anne Braae, Allanore, Yannick, Henes, Joerg Christoph, Müller-Ladner, Ulf, Riemekasten, Gabriela, Skapenko, Alla, Vlachoyiannopoulos, Panayiotis, Kiss, Emese, Minier, Tünde, Beretta, Lorenzo, Gremese, Elisa, Matucci-Cerinic, Marco, Valentini, Gabriele, Asano, Yoshihide, Atsumi, Tatsuya, Ihn, Hironobu, Ishii, Tomonori, Ishikawa, Osamu, Kuwana, Masataka, Shima, Yoshihito, Takahashi, Hiroki, Takehara, Kazuhiko, Tanaka, Yoshiya, Yamasaki, Yoshioki, Bukauskiene, Loreta, Butrimiene, Irena, Medrano Ramirez, Gabriel, Ramos-Remus, Cesar, Sofia Rodriguez Reyna, Tatiana, de Vries-Bouwstra, Jeska, van Laar, Jacob M., Batko, Bogdan, Jeka, Slawomir, Kucharz, Eugeniusz, Majdan, Maria, Olesinska, Marzena, Smolenska, Zaneta, Alves, Jose, Santos, Maria, Mihai, Carmen Marina, Rednic, Simona, Castellvi Barranco, Ivan, Lopez Longo, Francisco Javier, Simeon Aznar, Carmen, Carreira, Patricia, Distler, Oliver, Walker, Ulrich A., Derrett-Smith, Emma, Griffiths, Bridget, McKay, Neil, Denton, Christopher P., Aelion, Jacob, Borofsky, Michael, Fleischmann, Roy, Forstot, Joseph Z., Furst, Daniel E., Kafaja, Suzanne, Khan, M. Faisal, Khanna, Dinesh, Kohen, Michael D., Martin, Richard W., Mendoza-Ballesteros, Fabian, Nami, Alireza, Pang, Shirley, Rios, Grissel, Simms, Robert, Sullivan, Keith Michael, Steen, Virginia D., Lin, Celia J F, Furst, Daniel E, Goldin, Jonathan, Kim, Grace, van Laar, Jacob M, Spotswood, Helen, Wagner, Bridget, Siegel, Jeffrey, Jahreis, Angelika, and Denton, Christopher P

Published
2020
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20. Evaluation of the educational needs in Argentine patients with rheumatoid arthritis using the SpENAT questionnaire

Author

Pérez, Silvana, Santa Cruz, María, Sosa, Julia, Kohan, Paula, Medina, María, Klajn, Diana, Papasidero, Silvia, Caracciolo, José, Pendón, Gisela, Giordano, Federico, Pereira, Dora, Alvarez, Damaris, Astudillo, Valeria, Kerzberg, Eduardo, Perez Dávila, Adriana, Bohr, Analía, Melo, Fernando, Lloves, Nicolás, Mamani, Marta, Hartvig, Claudia, Sanchez, Gabriela, Sacnum, Mónica, Chichotky, Yamila, Velazco Zamora, José, Benegas, Mariana, Rosa, Javier, García, María, Raiti, Laura, Cruzat, Vanesa, Quintana, Rosana, Pons-Estel, Bernardo, Kirmayr, Karin, D’Orazio, Andrea, Retamozo, Cinthya, Romano, Olga, Perez Alamino, Rodolfo, Correa, María, Citera, Gustavo, Rillo, Oscar, Zalazar, María, Costi, Ana, García, Mercedes, Gomez, Graciela, and Maldonado Ficco, Hernán

Published
2020
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21. Evaluación de las necesidades educacionales de los pacientes con artritis reumatoide mediante el cuestionario SpENAT

Author

Pérez, Silvana, Santa Cruz, María, Sosa, Julia, Kohan, Paula, Medina, María, Klajn, Diana, Papasidero, Silvia, Caracciolo, José, Pendón, Gisela, Giordano, Federico, Pereira, Dora, Alvarez, Damaris, Astudillo, Valeria, Kerzberg, Eduardo, Perez Dávila, Adriana, Bohr, Analía, Melo, Fernando, Lloves, Nicolás, Mamani, Marta, Hartvig, Claudia, Sanchez, Gabriela, Sacnum, Mónica, Chichotky, Yamila, Velazco Zamora, José, Benegas, Mariana, Rosa, Javier, García, María, Raiti, Laura, Cruzat, Vanesa, Quintana, Rosana, Pons-Estel, Bernardo, Kirmayr, Karin, D’Orazio, Andrea, Retamozo, Cinthya, Romano, Olga, Perez Alamino, Rodolfo, Correa, María, Citera, Gustavo, Rillo, Oscar, Zalazar, María, Costi, Ana, García, Mercedes, Gomez, Graciela, and Maldonado Ficco, Hernán

Published
2020
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25. Letʼs Talk About Lupus. Overview of an Innovative, High-Reach, Online Program to Fill the Education Gaps of Latin Americans Living With Lupus

Author

Drenkard, Cristina, Fuentes-Silva, Yurilis, Parente Costa Seguro, Luciana, Torres dos Reis-Neto, Edgard, Ibañez, Soledad, Elera-Fitzcarrald, Claudia, Reategui-Sokolova, Cristina, Linhares, Fernanda Athayde, Bermúdez, Witjal, Ferreyra-Garrot, Leandro, Acosta, Carlota, Caballero-Uribe, Carlo V., Sato, Emilia Inoue, Bonfa, Eloisa, and Pons-Estel, Bernardo A.

Published
2022
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27. EULAR recommendations for the management of systemic lupus erythematosus: 2023 update

Author

Fanouriakis, Antonis, primary, Kostopoulou, Myrto, additional, Andersen, Jeanette, additional, Aringer, Martin, additional, Arnaud, Laurent, additional, Bae, Sang-Cheol, additional, Boletis, John, additional, Bruce, Ian N, additional, Cervera, Ricard, additional, Doria, Andrea, additional, Dörner, Thomas, additional, Furie, Richard A, additional, Gladman, Dafna D, additional, Houssiau, Frederic A, additional, Inês, Luís Sousa, additional, Jayne, David, additional, Kouloumas, Marios, additional, Kovács, László, additional, Mok, Chi Chiu, additional, Morand, Eric F, additional, Moroni, Gabriella, additional, Mosca, Marta, additional, Mucke, Johanna, additional, Mukhtyar, Chetan B, additional, Nagy, György, additional, Navarra, Sandra, additional, Parodis, Ioannis, additional, Pego-Reigosa, José M, additional, Petri, Michelle, additional, Pons-Estel, Bernardo A, additional, Schneider, Matthias, additional, Smolen, Josef S, additional, Svenungsson, Elisabet, additional, Tanaka, Yoshiya, additional, Tektonidou, Maria G, additional, Teng, YK Onno, additional, Tincani, Angela, additional, Vital, Edward M, additional, van Vollenhoven, Ronald F, additional, Wincup, Chris, additional, Bertsias, George, additional, and Boumpas, Dimitrios T, additional

Published
2023
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29. Clinical predictors of remission and low disease activity in Latin American early rheumatoid arthritis: data from the GLADAR cohort

Author

Gamboa-Cárdenas, Rocio V, Ugarte-Gil, Manuel F., Loreto, Massardo, Sacnun, Mónica P., Saurit, Verónica, Cardiel, Mario H., Soriano, Enrique R., Pisoni, Cecilia, Galarza-Maldonado, Claudio M., Rios, Carlos, Radominski, Sebastião C., Castelar-Pinheiro, Geraldo da R., Bianchi, Washington Alves, Appenzeller, Simone, da Silveira, Inés Guimarães, de Freitas Zerbini, Cristiano A., Caballero-Uribe, Carlo V., Rojas-Villarraga, Adriana, Guibert-Toledano, Marlene, Ballesteros, Francisco, Montufar, Rubén, Vázquez-Mellado, Janitzia, Esquivel-Valerio, Jorge, De La Torre, Ignacio García, Barile-Fabris, Leonor A., Palezuelos, Fedra Irazoque, Andrade-Ortega, Lilia, Monge, Pablo, Teijeiro, Raquel, Achurra-Castillo, Ángel F., Esteva Spinetti, María H., Alarcón, Graciela S., and Pons-Estel, Bernardo A.

Published
2019
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30. Unraveling Multiple MHC Gene Associations with Systemic Lupus Erythematosus: Model Choice Indicates a Role for HLA Alleles and Non-HLA Genes in Europeans

Author

Morris, David L, Taylor, Kimberly E, Fernando, Michelle MA, Nititham, Joanne, Alarcón-Riquelme, Marta E, Barcellos, Lisa F, Behrens, Timothy W, Cotsapas, Chris, Gaffney, Patrick M, Graham, Robert R, Pons-Estel, Bernardo A, Gregersen, Peter K, Harley, John B, Hauser, Stephen L, Hom, Geoffrey, Network, International MHC and Autoimmunity Genetics, Langefeld, Carl D, Noble, Janelle A, Rioux, John D, Seldin, Michael F, Consortium, Systemic Lupus Erythematosus Genetics, Criswell, Lindsey A, and Vyse, Timothy J

Subjects
Biological Sciences, Biomedical and Clinical Sciences, Genetics, Immunology, Clinical Research, Autoimmune Disease, Lupus, 2.1 Biological and endogenous factors, Aetiology, Inflammatory and immune system, Alleles, Gene Expression Profiling, Genetic Predisposition to Disease, Genotype, HLA Antigens, HLA-B Antigens, HLA-C Antigens, HLA-DQ alpha-Chains, HLA-DRB1 Chains, Haplotypes, Humans, Lupus Erythematosus, Systemic, Major Histocompatibility Complex, Polymorphism, Single Nucleotide, White People, International MHC and Autoimmunity Genetics Network, Systemic Lupus Erythematosus Genetics Consortium, Medical and Health Sciences, Genetics & Heredity, Biological sciences, Biomedical and clinical sciences, Health sciences
Abstract

We have performed a meta-analysis of the major-histocompatibility-complex (MHC) region in systemic lupus erythematosus (SLE) to determine the association with both SNPs and classical human-leukocyte-antigen (HLA) alleles. More specifically, we combined results from six studies and well-known out-of-study control data sets, providing us with 3,701 independent SLE cases and 12,110 independent controls of European ancestry. This study used genotypes for 7,199 SNPs within the MHC region and for classical HLA alleles (typed and imputed). Our results from conditional analysis and model choice with the use of the Bayesian information criterion show that the best model for SLE association includes both classical loci (HLA-DRB1(∗)03:01, HLA-DRB1(∗)08:01, and HLA-DQA1(∗)01:02) and two SNPs, rs8192591 (in class III and upstream of NOTCH4) and rs2246618 (MICB in class I). Our approach was to perform a stepwise search from multiple baseline models deduced from a priori evidence on HLA-DRB1 lupus-associated alleles, a stepwise regression on SNPs alone, and a stepwise regression on HLA alleles. With this approach, we were able to identify a model that was an overwhelmingly better fit to the data than one identified by simple stepwise regression either on SNPs alone (Bayes factor [BF] > 50) or on classical HLA alleles alone (BF > 1,000).

Published
2012

31. Association of two independent functional risk haplotypes in TNIP1 with systemic lupus erythematosus

Author

Adrianto, Indra, Wang, Shaofeng, Wiley, Graham B, Lessard, Christopher J, Kelly, Jennifer A, Adler, Adam J, Glenn, Stuart B, Williams, Adrienne H, Ziegler, Julie T, Comeau, Mary E, Marion, Miranda C, Wakeland, Benjamin E, Liang, Chaoying, Kaufman, Kenneth M, Guthridge, Joel M, Alarcón‐Riquelme, Marta E, Networks, BIOLUPUS and GENLES, Alarcón, Graciela S, Anaya, Juan‐Manuel, Bae, Sang‐Cheol, Kim, Jae‐Hoon, Bin Joo, Young, Boackle, Susan A, Brown, Elizabeth E, Petri, Michelle A, Ramsey‐Goldman, Rosalind, Reveille, John D, Vilá, Luis M, Criswell, Lindsey A, Edberg, Jeffrey C, Freedman, Barry I, Gilkeson, Gary S, Jacob, Chaim O, James, Judith A, Kamen, Diane L, Kimberly, Robert P, Martín, Javier, Merrill, Joan T, Niewold, Timothy B, Pons‐Estel, Bernardo A, Scofield, R Hal, Stevens, Anne M, Tsao, Betty P, Vyse, Timothy J, Langefeld, Carl D, Harley, John B, Wakeland, Edward K, Moser, Kathy L, Montgomery, Courtney G, and Gaffney, Patrick M

Subjects
Biological Sciences, Biomedical and Clinical Sciences, Genetics, Clinical Research, Human Genome, Lupus, Autoimmune Disease, 2.1 Biological and endogenous factors, Aetiology, Inflammatory and immune system, Adaptor Proteins, Signal Transducing, Black or African American, Asian, B-Lymphocytes, Cell Line, Transformed, DNA-Binding Proteins, Female, Genetic Markers, Genetic Predisposition to Disease, Haplotypes, Hispanic or Latino, Humans, Intracellular Signaling Peptides and Proteins, Lupus Erythematosus, Systemic, Male, Neoplasm Proteins, Polymorphism, Single Nucleotide, Risk Factors, United States, White People, BIOLUPUS and GENLES Networks, Clinical Sciences, Immunology, Public Health and Health Services, Arthritis & Rheumatology, Clinical sciences
Abstract

ObjectiveSystemic lupus erythematosus (SLE) is an autoimmune disease characterized by autoantibody production and altered type I interferon expression. Genetic surveys and genome-wide association studies have identified >30 SLE susceptibility genes. One of these genes, TNIP1, encodes the ABIN1 protein. ABIN1 functions in the immune system by restricting NF-κB signaling. The present study was undertaken to investigate the genetic factors that influence association with SLE in genes that regulate the NF-κB pathway.MethodsWe analyzed a dense set of genetic markers spanning TNIP1 and TAX1BP1, as well as the TNIP1 homolog TNIP2, in case-control populations of diverse ethnic origins. TNIP1, TNIP2, and TAX1BP1 were fine-mapped in a total of 8,372 SLE cases and 7,492 healthy controls from European-ancestry, African American, Hispanic, East Asian, and African American Gullah populations. Levels of TNIP1 messenger RNA (mRNA) and ABIN1 protein in Epstein-Barr virus-transformed human B cell lines were analyzed by quantitative reverse transcription-polymerase chain reaction and Western blotting, respectively.ResultsWe found significant associations between SLE and genetic variants within TNIP1, but not in TNIP2 or TAX1BP1. After resequencing and imputation, we identified 2 independent risk haplotypes within TNIP1 in individuals of European ancestry that were also present in African American and Hispanic populations. Levels of TNIP1 mRNA and ABIN1 protein were reduced among subjects with these haplotypes, suggesting that they harbor hypomorphic functional variants that influence susceptibility to SLE by restricting ABIN1 expression.ConclusionOur results confirm the association signals between SLE and TNIP1 variants in multiple populations and provide new insight into the mechanism by which TNIP1 variants may contribute to SLE pathogenesis.

Published
2012

32. Impact of genetic ancestry and sociodemographic status on the clinical expression of systemic lupus erythematosus in American Indian–European populations

Author

Sánchez, Elena, Rasmussen, Astrid, Riba, Laura, Acevedo‐Vasquez, Eduardo, Kelly, Jennifer A, Langefeld, Carl D, Williams, Adrianne H, Ziegler, Julie T, Comeau, Mary E, Marion, Miranda C, La Torre, Ignacio García‐De, Maradiaga‐Ceceña, Marco A, Cardiel, Mario H, Esquivel‐Valerio, Jorge A, Rodriguez‐Amado, Jacqueline, Moctezuma, José Francisco, Miranda, Pedro, Perandones, Carlos E, Castel, Cecilia, Laborde, Hugo A, Alba, Paula, Musuruana, Jorge L, Goecke, I Annelise, Anaya, Juan‐Manuel, Kaufman, Kenneth M, Adler, Adam, Glenn, Stuart B, Brown, Elizabeth E, Alarcón, Graciela S, Kimberly, Robert P, Edberg, Jeffrey C, Vilá, Luis M, Criswell, Lindsey A, Gilkeson, Gary S, Niewold, Timothy B, Martín, Javier, Vyse, Timothy J, Boackle, Susan A, Ramsey‐Goldman, Rosalind, Scofield, R Hal, Petri, Michelle, Merrill, Joan T, Reveille, John D, Tsao, Betty P, Orozco, Lorena, Baca, Vicente, Moser, Kathy L, Gaffney, Patrick M, James, Judith A, Harley, John B, Tusié‐Luna, Teresa, Pons‐Estel, Bernardo A, Jacob, Chaim O, and Alarcón‐Riquelme, Marta E

Subjects
Biological Sciences, Biomedical and Clinical Sciences, Health Sciences, Genetics, Autoimmune Disease, Clinical Research, Lupus, Kidney Disease, American Indian or Alaska Native, Inflammatory and immune system, Adolescent, Adult, Child, Female, Genetic Predisposition to Disease, Genotype, Humans, Indians, North American, Indians, South American, Lupus Erythematosus, Systemic, Lupus Nephritis, Male, Middle Aged, Morbidity, Prevalence, Risk Factors, Socioeconomic Factors, White People, Young Adult, Clinical Sciences, Immunology, Public Health and Health Services, Arthritis & Rheumatology, Clinical sciences
Abstract

ObjectiveAmerican Indian-Europeans, Asians, and African Americans have an excess morbidity from systemic lupus erythematosus (SLE) and a higher prevalence of lupus nephritis than do Caucasians. The aim of this study was to analyze the relationship between genetic ancestry and sociodemographic characteristics and clinical features in a large cohort of American Indian-European SLE patients.MethodsA total of 2,116 SLE patients of American Indian-European origin and 4,001 SLE patients of European descent for whom we had clinical data were included in the study. Genotyping of 253 continental ancestry-informative markers was performed on the Illumina platform. Structure and Admixture software were used to determine genetic ancestry proportions of each individual. Logistic regression was used to test the association between genetic ancestry and sociodemographic and clinical characteristics. Odds ratios (ORs) were calculated with 95% confidence intervals (95% CIs).ResultsThe average American Indian genetic ancestry of 2,116 SLE patients was 40.7%. American Indian genetic ancestry conferred increased risks of renal involvement (P < 0.0001, OR 3.50 [95% CI 2.63- 4.63]) and early age at onset (P < 0.0001). American Indian ancestry protected against photosensitivity (P < 0.0001, OR 0.58 [95% CI 0.44-0.76]), oral ulcers (P < 0.0001, OR 0.55 [95% CI 0.42-0.72]), and serositis (P < 0.0001, OR 0.56 [95% CI 0.41-0.75]) after adjustment for age, sex, and age at onset. However, age and sex had stronger effects than genetic ancestry on malar rash, discoid rash, arthritis, and neurologic involvement.ConclusionIn general, American Indian genetic ancestry correlates with lower sociodemographic status and increases the risk of developing renal involvement and SLE at an earlier age.

Published
2012

33. Evaluation of TRAF6 in a large multiancestral lupus cohort

Author

Namjou, Bahram, Choi, Chan‐Bum, Harley, Isaac TW, Alarcón‐Riquelme, Marta E, Network, BIOLUPUS, Kelly, Jennifer A, Glenn, Stuart B, Ojwang, Joshua O, Adler, Adam, Kim, Kwangwoo, Gallant, Caroline J, Boackle, Susan A, Criswell, Lindsey A, Kimberly, Robert P, Brown, Elizabeth E, Edberg, Jeffrey, Alarcón, Graciela S, Stevens, Anne M, Jacob, Chaim O, Gilkeson, Gary S, Kamen, Diane L, Tsao, Betty P, Anaya, Juan‐Manuel, Kim, Eun‐Mi, Park, So‐Yeon, Sung, Yoon‐Kyoung, Guthridge, Joel M, Merrill, Joan T, Petri, Michelle, Ramsey‐Goldman, Rosalind, Vilá, Luis M, Niewold, Timothy B, Martin, Javier, Pons‐Estel, Bernardo A, Network, Genoma en Lupus, Vyse, Timothy J, Freedman, Barry I, Moser, Kathy L, Gaffney, Patrick M, Williams, Adrienne H, Comeau, Mary E, Reveille, John D, Kang, Changwon, James, Judith A, Scofield, R Hal, Langefeld, Carl D, Kaufman, Kenneth M, Harley, John B, and Bae, Sang‐Cheol

Subjects
Biological Sciences, Biomedical and Clinical Sciences, Genetics, Epidemiology, Health Sciences, Lupus, Clinical Research, Arthritis, Autoimmune Disease, 2.1 Biological and endogenous factors, Aetiology, Inflammatory and immune system, Alleles, Case-Control Studies, Cohort Studies, Female, Gene Frequency, Genetic Association Studies, Genetic Predisposition to Disease, Genotype, Haplotypes, Humans, Lupus Erythematosus, Systemic, Male, Polymorphism, Single Nucleotide, TNF Receptor-Associated Factor 6, BIOLUPUS Network, Genoma en Lupus Network, Clinical Sciences, Immunology, Public Health and Health Services, Arthritis & Rheumatology, Clinical sciences
Abstract

ObjectiveSystemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease with significant immune system aberrations resulting from complex heritable genetics as well as environmental factors. We undertook to study the role of TRAF6 as a candidate gene for SLE, since it plays a major role in several signaling pathways that are important for immunity and organ development.MethodsFifteen single-nucleotide polymorphisms (SNPs) across TRAF6 were evaluated in 7,490 SLE patients and 6,780 control subjects from different ancestries. Population-based case-control association analyses and meta-analyses were performed. P values, false discovery rate q values, and odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated.ResultsEvidence of associations was detected in multiple SNPs. The best overall P values were obtained for SNPs rs5030437 and rs4755453 (P = 7.85 × 10(-5) and P = 4.73 × 10(-5) , respectively) without significant heterogeneity among populations (P = 0.67 and P = 0.50, respectively, in Q statistic). In addition, SNP rs540386, which was previously reported to be associated with rheumatoid arthritis (RA), was found to be in linkage disequilibrium with these 2 SNPs (r(2) = 0.95) and demonstrated evidence of association with SLE in the same direction (meta-analysis P = 9.15 × 10(-4) , OR 0.89 [95% CI 0.83-0.95]). The presence of thrombocytopenia improved the overall results in different populations (meta-analysis P = 1.99 × 10(-6) , OR 0.57 [95% CI 0.45-0.72], for rs5030470). Finally, evidence of family-based association in 34 African American pedigrees with the presence of thrombocytopenia was detected in 1 available SNP (rs5030437) with a Z score magnitude of 2.28 (P = 0.02) under a dominant model.ConclusionOur data indicate the presence of association of TRAF6 with SLE, consistent with the previous report of association with RA. These data provide further support for the involvement of TRAF6 in the pathogenesis of autoimmunity.

Published
2012

35. LSO-086 Pregnancy outcomes in systemic lupus erythematosus: data from a multiethnic, multinational Latin American cohort

Author

Serrano Morales, Rosa M, primary, Nieto, Romina, additional, Quintana, Rosana, additional, Alba, Paula, additional, Porta, Sabrina, additional, Hernandez, Lucia, additional, Berbotto, Guillermo A, additional, Bellomio, Verónica, additional, Silva, Nilzio Antonio Da, additional, Monticielo, Odirlei Andre, additional, Cavalcanti, Fernando De Souza, additional, Ribeiro, Francinne Machado, additional, Borba, Eduardo F, additional, Bonfa, Eloisa, additional, Massardo, Loreto, additional, Martinez, Gustavo Aroca, additional, Bonfanti, Andrés Cadena, additional, López, Gerardo Quintana, additional, Moreno, Mario, additional, Esquivel Valerio, Jorge A, additional, Acosta, María I, additional, Nicora, Astrid Paats, additional, Mora Trujillo, Claudia S, additional, Scolnik, Marina, additional, Fernandez, Diana, additional, Soaje, Carmen Funes, additional, Saurit, Verónica, additional, García, Mercedes, additional, Kerzberg, Eduardo, additional, Gómez, Graciela, additional, Pisoni, Cecilia, additional, dos Reis Neto, Edgard Torres, additional, Herrera, Iris Guerra, additional, Quiroga, Oscar Neira, additional, Cañas, Carlos A, additional, Saavedra Salinas, Miguel A, additional, Hernández, Margarita Portela, additional, Loyo, Hilda Fragoso, additional, Silveira, Luis H, additional, Torre, Ignacio García de la, additional, Ugarte-Gil, Manuel, additional, Calvo-Quiroz, Armando, additional, Louis, Roberto Muñoz, additional, Robaina, Ricardo, additional, Juárez, Vicente, additional, Danza, Álvaro, additional, Toro-Gutierrez, Carlos E, additional, Mendoza, Carlos Abud, additional, Malvar, Ana, additional, Alarcón, Graciela S, additional, Orillion, Ashley, additional, Sbarigia, Urbano, additional, Zazzetti, Federico, additional, Pons-Estel, Guillermo J, additional, and Pons-Estel, Bernardo A, additional

Published
2023
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36. LP-149 Latin-American systemic lupus erythematosus clusters

Author

Quintana, Rosana, primary, Nieto, Romina, additional, Pons-Estel, Guillermo J, additional, Gómez Puerta, José, additional, Harvey, Guillermina, additional, Scolnik, Marina, additional, Meras, Nidia, additional, Otaduy, Cintia, additional, Novati, Elisa, additional, Arturi, Valeria, additional, Sattler, María Emilia, additional, Lucero, Luciana González, additional, Grageda, Wilfredo Patiño, additional, Pérez, Nicolás, additional, Pisoni, Cecilia, additional, De Oliveirae Silva Montaton, Ana Carolina, additional, Monticielo, Odirlei Andre, additional, Duarte, Angela, additional, Ribeiro, Francinne Machado, additional, Neves Yuki, Emily Figueiredo, additional, Reis-Neto, Edgard Torres Dos, additional, Guerra, Iris, additional, Davet, Milena Mimica, additional, Martínez, Gustavo Aroca, additional, Tobón, Gabriel J, additional, Quintana-Lopez, Gerardo, additional, Bonfanti, Andrés Cadena, additional, Álvarez, Mario Moreno, additional, Saavedra Salinas, Miguel Angel, additional, Hernández, Margarita Portela, additional, Loyo, Hilda Fragoso, additional, Silveira, Luis H, additional, García valladares, Ignacio, additional, Mendoza, Carlos Abud, additional, Esquivel-Valerio, Jorge A, additional, Martinez, Maria Teresa, additional, Duarte, Margarita, additional, Mora Trujillo, Claudia Selene, additional, Ugarte-Gil, Manuel, additional, Ernesto, S, additional, louis, Roberto Muñoz, additional, Robaina, Ricardo, additional, Juarez, Vicente, additional, Silveira, Gonzalo, additional, Borba, Eduardo, additional, Catoggio, Luis J, additional, Alarcón, Graciela S, additional, Zazzetti, Federico, additional, Orillion, Ashley, additional, Sbarigia, Urbano, additional, and Pons-Estel, Bernardo A, additional

Published
2023
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37. LP-061 Male sex and disease activity at diagnosis are predictors of severe hemolytic anemia in patients with systemic lupus erythematosus: data from a multiethnic Latin American cohort

Author

González, Luis A, primary, Alarcón, Graciela S, additional, Harvey, Guillermina B, additional, Quintana, Rosana, additional, Pons-estel, Guillermo J, additional, Ugarte-gil, Manuel F, additional, Vásquez, Gloria, additional, Catoggio, Luis J, additional, García, Mercedes A, additional, Borba, Eduardo F, additional, Da silva, Nilzio A, additional, João, C, additional, toledano, Marlene Guibert, additional, Massardo, Loreto, additional, Neira, Oscar, additional, Pascual-ramos, Virginia, additional, Amigo, Mary-Carmen, additional, Barile-fabris, Leonor A, additional, torre, Ignacio García de la, additional, Alfaro-lozano, José, additional, Segami, María I, additional, Chacón-díaz, Rosa, additional, Esteva-spinetti, María H, additional, Iglesias-gamarra, Antonio, additional, and Pons-estel, Bernardo A, additional

Published
2023
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38. LP-141 Delay to diagnosis of systemic lupus erythematosus and its impact on cumulative damage and mortality: data from a multiethnic Latin American cohort

Author

Nieto, Romina, primary, Quintana, Rosana, additional, Zavala, Ernesto, additional, Serrano Morales, Rosa Maria, additional, Roberts, Karen, additional, Harvey, Guillermina B, additional, Acevedo-Vásquez, Eduardo, additional, Barile, Leonor, additional, Costallat, Lilian Lavras, additional, Neira, Oscar, additional, Chacon, Rosa, additional, Silva, Nílzio Da, additional, Molina-Restrepo, José Fernando, additional, Gamarra, Antonio Iglesias, additional, Alarcon, Graciela S, additional, Pons-Estel, Bernardo, additional, and Pons-Estel, Guillermo, additional

Published
2023
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39. Frecuencia de eventos cardiovasculares en pacientes con lupus eritematoso sistémico. Datos del registro RELESSAR transversal

Author

García, Lucila, primary, Gobbi, Carla, additional, Quintana, Rosana, additional, Alba, Paula, additional, Roverano, Susana, additional, Álvarez, Analía, additional, Graf, César, additional, Pisoni, Cecilia, additional, Spindler, Alberto, additional, Gómez, Catalina, additional, Figueredo, Heber Matías, additional, Papasidero, Silvia, additional, Paniego, Raúl, additional, De la Vega, María Celina, additional, Civit, Emma, additional, González Lucero, Luciana, additional, Martire, María Victoria, additional, Maldonado Aguila, Rodrigo, additional, Gordon, Sergio, additional, Micelli, Marina, additional, Nieto, Romina, additional, Rausch, Gretel, additional, Gongora, Vanina, additional, Damico, Agustina, additional, Dubinsky, Diana, additional, Orden, Alberto, additional, Zacariaz, Johana, additional, Romero, Julia, additional, Pera, Mariana, additional, Goñi, Mario, additional, Rillo, Oscar, additional, Báez, Roberto, additional, Arturi, Valeria, additional, González, Andrea, additional, Vivero, Florencia, additional, Bedoya, María Eugenia, additional, Shmid, Marcela, additional, Caputo, Víctor, additional, Larroude, María Silvia, additional, Domínguez, Nadia, additional, Gómez, Graciela, additional, Rodríguez, Graciela, additional, Marín, Josefina, additional, Collado, Victoria, additional, Jorfen, Marisa, additional, Bedran, Zaida, additional, Curti, Ana, additional, Gazzoni, María Victoria, additional, Sarano, Judith, additional, Finucci Curi, Pablo, additional, Rojas Tessel, Romina, additional, Arias Saavedra, Maira, additional, Sattler, María Emilia, additional, Machado Escobar, Maximiliano, additional, Astesana, Pablo, additional, París, Úrsula, additional, Vandale, Juan Manuel, additional, Santa Cruz, María Julia, additional, Pons-Estel, Bernardo, additional, and García, Mercedes, additional

Published
2023
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40. Rheumatoid arthritis in the indigenous qom population of Rosario, Argentina: aggressive and disabling disease with inadequate adherence to treatment in a community-based cohort study

Author

Quintana, Rosana, Goñi, Mario, Mathern, Nora, Jorfen, Marisa, Conti, Silvana, Nieto, Romina, Sanabria, Alvaro, Prigione, Cristina, Silvestre, Adriana M. R., García, Vanina, Pons-Estel, Guillermo, Cervera, Ricard, García, Conrado, Peláez-Ballestas, Ingris, Alarcón, Graciela S., and Pons-Estel, Bernardo A.

Published
2018
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41. Predictors of severe hemolytic anemia and its impact on major outcomes in systemic lupus erythematosus: Data from a multiethnic Latin American cohort

Author

González, Luis Alonso, primary, Alarcón, Graciela S., additional, Harvey, Guillermina B, additional, Quintana, Rosana, additional, Pons-Estel, Guillermo J, additional, Ugarte-Gil, Manuel F, additional, Vásquez, Gloria, additional, Catoggio, Luis J, additional, García, Mercedes A., additional, Borba, Eduardo F, additional, Da Silva, Nilzio A, additional, Tavares Brenol, João C, additional, Toledano, Marlene Guibert, additional, Massardo, Loreto, additional, Neira, Oscar, additional, Pascual-Ramos, Virginia, additional, Amigo, Mary-Carmen, additional, Barile-Fabris, Leonor A, additional, De La Torre, Ignacio García, additional, Alfaro-Lozano, José, additional, Segami, María I, additional, Chacón-Díaz, Rosa, additional, Esteva-Spinetti, María H, additional, Iglesias-Gamarra, Antonio, additional, and Pons-Estel, Bernardo A, additional

Published
2023
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42. Seguridad de las drogas biológicas y sintéticas dirigidas utilizadas en pacientes con enfermedades reumáticas inmunomediadas. Datos del registro BIOBADASAR 3.0

Author

Isnardi, Carolina A., primary, Roberts, Karen, additional, Exeni, Ida, additional, De La Sota, Mercedes, additional, Soriano, Enrique, additional, Dubinsky, Diana, additional, Medina, Gustavo, additional, Berbotto, Guillermo A., additional, Velozo, Edson J., additional, Papasidero, Silvia, additional, Gamba, Julieta, additional, Saurit, Verónica, additional, Citera, Gustavo, additional, Díaz, Mónica, additional, Catay, Erika, additional, Gómez, Graciela, additional, Sacnun, Mónica, additional, Larroude, María S., additional, Cavillon, Emilia, additional, Secco, Anastasia, additional, Aste, Nora, additional, Pons-Estel, Bernardo, additional, García, Mercedes A., additional, Pisoni, Cecilia, additional, Bovea, Gladys, additional, Morales, Liliana, additional, Granel, Amelia, additional, Gobbi, Carla, additional, Savio, Verónica, additional, Álvarez, Analia P., additional, Casado, Gustavo, additional, Soares Souza, Sidney, additional, Petkovic, Ingrid, additional, Castro, Cecilia, additional, Kerzberg, Osvaldo, additional, Gallardo, María de los Ángeles, additional, Brigante, Alejandro, additional, Salinas, María Haye, additional, Alfaro, María Agustina, additional, Pons-Estel, Guillermo J., additional, and De La Vega, María Celina, additional

Published
2023
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43. Inequity and vulnerability in Latin American Indigenous and non-Indigenous populations with rheumatic diseases: a syndemic approach

Author

Granados, Ysabel, primary, Gastelum Strozzi, Alfonso, additional, Alvarez-Nemegyei, Jose, additional, Quintana, Rosana, additional, Julian-Santiago, Flor, additional, Santos, Ana M, additional, Guevara-Pacheco, Sergio, additional, Loyola-Sanchez, Adalberto, additional, Goycochea-Robles, Maria Victoria, additional, Juarez, Vicente, additional, Garza-Elizondo, Mario Alberto, additional, Rueda, Juan Camilo, additional, Burgos-Vargas, Ruben, additional, Londoño, John, additional, Pons-Estel, Bernardo A, additional, and Pelaez-Ballestas, Ingris, additional

Published
2023
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44. Guía ¿Es lupus? : educando sobre lupus a médicos de atención primaria y futuros médicos de América Latina

Author

Laboratorio Curie S.R.L, Acosta Colmán (de Conrads), María Isabel, Cairoli Morossini, Ernesto Carlos, Catoggio, Luis J., Drenkard, Cristina, Ferreyra Garrot, Leandro, Fuentes Silva, Yurilís, Guaglianone, Débora, Martínez de Filártiga Filártiga, María Teresa, Pons-Estel, Bernardo A., Pons-Estel, Guillermo Javier, Toro Gutiérrez, Carlos Enrique, Laboratorio Curie S.R.L, Acosta Colmán (de Conrads), María Isabel, Cairoli Morossini, Ernesto Carlos, Catoggio, Luis J., Drenkard, Cristina, Ferreyra Garrot, Leandro, Fuentes Silva, Yurilís, Guaglianone, Débora, Martínez de Filártiga Filártiga, María Teresa, Pons-Estel, Bernardo A., Pons-Estel, Guillermo Javier, and Toro Gutiérrez, Carlos Enrique

Abstract

La presente guía no pretende ser un texto sobre lupus sino ayudar a los médicos de atención primaria de la salud, médicos de familia y clínicos a tener conceptos claros para poder sospechar tempranamente esta enfermedad, y así organizar el viaje más adecuado de transferencia con el especialista en el tema, y contratransferencia con el médico de cabecera para evitar consecuencias para las/os pacientes, a veces graves. En enfermedades multisistémicas con manifestaciones tan variadas como el lupus, su reconocimiento no es fácil, particularmente si no se lo sospecha, y el retraso en el diagnóstico es tan frecuente como perjudicial para los pacientes por el daño progresivo que conlleva. Esta guía tiene la característica de estar escrita por reumatólogos o internistas con interés en esta enfermedad que, además, y esto es esencial, tienen interés en la interrelación con los médicos de atención primaria para juntos planificar y establecer estrategias educativas que permitan el diagnóstico temprano y el tratamiento oportuno de los pacientes con una enfermedad tan compleja como es el lupus. De ahí el enfoque práctico. Es posible que algunos capítulos ahonden un poco en algunas áreas, pero la intención es alertar a los médicos que ven primero a estos pacientes, aumentar el índice de sospecha y derivar tempranamente a estos pacientes al especialista. También esperamos que quede claro el rol del médico de cabecera en la atención de estos pacientes y su manejo en conjunto con el reumatólogo o internista especializado para beneficio de los pacientes. Así, capítulos como “¿Qué debe saber el clínico sobre lupus?”, “Derivación oportuna” y, muy fundamentalmente, “Autogestión del paciente con lupus” contribuyen con este objetivo. El empoderamiento de las/os pacientes con lupus es esencial y debe ser reconocido y fomentado por todos nosotros. Esperamos que esta guía sea de ayuda tanto para los médicos que primero ven a estos pacientes como para estudiantes avanzados de medicina.

Published
2023

45. Klinefelter's syndrome (47,XXY) is in excess among men with Sjögren's syndrome

Author

Harris, Valerie M., Sharma, Rohan, Cavett, Joshua, Kurien, Biji T., Liu, Ke, Koelsch, Kristi A., Rasmussen, Astrid, Radfar, Lida, Lewis, David, Stone, Donald U., Kaufman, C. Erick, Li, Shibo, Segal, Barbara, Wallace, Daniel J., Weisman, Michael H., Venuturupalli, Swamy, Kelly, Jennifer A., Alarcon-Riquelme, Marta E., Pons-Estel, Bernardo, Jonsson, Roland, Lu, Xianglan, Gottenberg, Jacques-Eric, Anaya, Juan-Manuel, Cunninghame-Graham, Deborah S., Huang, Andrew J.W., Brennan, Michael T., Hughes, Pamela, Alevizos, Ilias, Miceli-Richard, Corinne, Keystone, Edward C., Bykerk, Vivian P., Hirschfield, Gideon, Xie, Gang, Ng, Wan-Fai, Nordmark, Gunnel, Bucher, Sara Magnusson, Eriksson, Per, Omdal, Roald, Rhodus, Nelson L., Rischmueller, Maureen, Rohrer, Michael, Wahren-Herlenius, Marie, Witte, Torsten, Mariette, Xavier, Lessard, Christopher J., Harley, John B., Sivils, Kathy L., and Scofield, R. Hal

Published
2016
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46. Differential Treatments Based on Drug-induced Gene Expression Signatures and Longitudinal Systemic Lupus Erythematosus Stratification

Author

Toro-Domínguez, Daniel, Lopez-Domínguez, Raúl, García Moreno, Adrián, Villatoro-García, Juan A., Martorell-Marugán, Jordi, Goldman, Daniel, Petri, Michelle, Wojdyla, Daniel, Pons-Estel, Bernardo A., Isenberg, David, Morales-Montes de Oca, Gabriela, Trejo-Zambrano, María Isabel, García González, Benjamín, Rosetti, Florencia, Gómez-Martín, Diana, Romero-Díaz, Juanita, Carmona-Sáez, Pedro, and Alarcón-Riquelme, Marta E.

Published
2019
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48. Evaluating the Construct of Damage in Systemic Lupus Erythematosus

Author

Johnson, Sindhu R., primary, Gladman, Dafna D., additional, Brunner, Hermine I., additional, Isenberg, David, additional, Clarke, Ann E., additional, Barber, Megan R. W., additional, Arnaud, Laurent, additional, Fortin, Paul R., additional, Mosca, Marta, additional, Voskuyl, Alexandre E., additional, Manzi, Susan, additional, Aranow, Cynthia, additional, Askanase, Anca, additional, Alarcón, Graciela S., additional, Bae, Sang‐Cheol, additional, Costedoat‐Chalumeau, Nathalie, additional, English, Jessica A., additional, Pons‐Estel, Guillermo J., additional, Pons‐Estel, Bernardo A., additional, Gilman, Rebecca, additional, Ginzler, Ellen M., additional, Hanly, John G., additional, Jacobsen, Soren, additional, Kalunian, Kenneth, additional, Kamen, Diane L., additional, Lambalgen, Chynace, additional, Legge, Alexandra, additional, Lim, S. Sam, additional, Mak, Anselm, additional, Morand, Eric F., additional, Peschken, Christine A., additional, Petri, Michelle, additional, Rahman, Anisur, additional, Ramsey‐Goldman, Rosalind, additional, Reynolds, John A., additional, Romero‐Diaz, Juanita, additional, Ruiz‐Irastorza, Guillermo, additional, Sanchez‐Guerrero, Jorge, additional, Svenungsson, Elisabet, additional, Touma, Zahi, additional, Urowitz, Murray, additional, Vinet, Evelyne, additional, van Vollenhoven, Ronald F., additional, Waldhauser, Heather, additional, Wallace, Daniel J., additional, Zoma, Asad, additional, and Bruce, Ian N., additional

Published
2022
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49. 603 Remission and low disease activity are associated with lower health care costs in an international inception cohort of patients with systemic lupus erythematosus

Author

Clarke, Ann E, primary, Ugarte-Gil, Manuel Francisco, additional, Barber, Megan RW, additional, Hanly, John G, additional, Urowitz, Murray B, additional, Pierre, Yvan St, additional, Gordon, Caroline, additional, Bae, Sang-Cheol, additional, Romero-Diaz, Juanita, additional, Sanchez-Guerrero, Jorge, additional, Bernatsky, Sasha, additional, Wallace, Daniel J, additional, Isenberg, David A, additional, Rahman, Anisur, additional, Merrill, Joan T, additional, Fortin, Paul R, additional, Gladman, Dafna D, additional, Bruce, Ian N, additional, Petri, Michelle, additional, Ginzler, Ellen M, additional, Dooley, Mary Anne, additional, Ramsey-Goldman, Rosalind, additional, Manzi, Susan, additional, Jönsen, Andreas, additional, Vollenhoven, Ronald FVan, additional, Aranow, Cynthia, additional, Mackay, Meggan, additional, Ruiz-Irastorza, Guillermo, additional, Sam Lim, S, additional, Inanc, Murat, additional, Kalunian, Kenneth C, additional, Jacobsen, Soren, additional, Peschken, Christine A, additional, Kamen, Diane L, additional, Askanase, Anca, additional, Pons-Estel, Bernardo A, additional, and Alarcón, Graciela S, additional

Published
2022
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50. Supplemental Material - Predictors of severe hemolytic anemia and its impact on major outcomes in systemic lupus erythematosus: Data from a multiethnic Latin American cohort

Author

González, Luis Alonso, Alarcón, Graciela S., Harvey, Guillermina B, Quintana, Rosana, Pons-Estel, Guillermo J, Ugarte-Gil, Manuel F, Vásquez, Gloria, Catoggio, Luis J, García, Mercedes A., Borba, Eduardo F, Da Silva, Nilzio A, Tavares Brenol, João C, Toledano, Marlene Guibert, Massardo, Loreto, Neira, Oscar, Pascual-Ramos, Virginia, Amigo, Mary-Carmen, Barile-Fabris, Leonor A, De La Torre, Ignacio García, Alfaro-Lozano, José, Segami, María I, Chacón-Díaz, Rosa, Esteva-Spinetti, María H, Iglesias-Gamarra, Antonio, and Pons-Estel, Bernardo A

Subjects
111702 Aged Health Care, FOS: Health sciences
Abstract

Supplemental Material for Predictors of severe hemolytic anemia and its impact on major outcomes in systemic lupus erythematosus: Data from a multiethnic Latin American cohort by Luis Alonso González, Graciela S. Alarcón, Guillermina B Harvey, Rosana Quintana, Guillermo J Pons-Estel, Manuel F Ugarte-Gil, Gloria Vásquez, Luis J Catoggio, Mercedes A. García, Eduardo F Borba, Nilzio A Da Silva, João C Tavares Brenol, Marlene Guibert Toledano, Loreto Massardo, Oscar Neira, Virginia Pascual-Ramos, Mary-Carmen Amigo, Leonor A Barile-Fabris, Ignacio García De La Torre, José Alfaro-Lozano, María I Segami, Rosa Chacón-Díaz, María H Esteva-Spinetti, Antonio Iglesias-Gamarra and Bernardo A Pons-Estel in Lupus

Published
2023
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