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Escalera CR, Guisado ÁMZ, Mateo FJ, Bahamontes-Rosa N, Villanueva MJG. Use of belimumab in real-world in Spain: a scoping review about characteristics of SLE patients. Clin Rheumatol 2022; 41:3373-3382. [PMID: 35871173 PMCID: PMC9308486 DOI: 10.1007/s10067-022-06287-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 07/04/2022] [Accepted: 07/06/2022] [Indexed: 11/29/2022]
Abstract
Background Belimumab was the first biological drug approved for Systemic Lupus Erythematosus (SLE). There is not a review focusing on all real-life experience with belimumab to date that could help to describe how this drug behaves in the Spanish clinical setting. Objective To describe the characteristics of SLE patients treated with belimumab added to standard of care in real-clinical setting in Spain. Methods We conducted a comprehensive scoping review of real-world data (RWD) according to PRISMA Scoping Reviews Checklist and the framework proposed by Arksey and O’Malley. PubMed and EMBASE were searched without language restriction and hand searches of relevant articles were examined. Results We included data from 222 patients treated with belimumab for SLE included in 19 RWD studies conducted in Spain. The mean age was 40.9 years, 84.2% were female, and baseline scores SELENA-SLEDAI ranged between 5.9 and 12. Lupus nephritis basal prevalence was of 2.7%. The main reason for belimumab initiation was previous treatments lack of efficacy (69.7%) and the most common laboratory abnormalities were hypocomplementemia (40.9%), ANA + (34.2%), and anti-DNA (33.3%). The addition of belimumab to standard therapy was associated with a reduction of daily glucocorticoids intake in 1.4–11.1 mg at 6 months. Belimumab discontinuation was observed in 18.6% of patients. Conclusion Our study helps to further explore the profile of SLE patients most likely to be treated with belimumab. Supplementary Information The online version contains supplementary material available at 10.1007/s10067-022-06287-9.
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Ito Y, Tamada T, Okunishi Y, Mizutani S, Yamamoto Y, Nakajima A. Organizing pneumonia as a possible pulmonary manifestation of systemic lupus erythematosus: Three cases and a review of literature. Lupus 2022; 31:737-743. [PMID: 35341381 DOI: 10.1177/09612033221088177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Organizing pneumonia (OP) is a rare manifestation of systemic lupus erythematosus (SLE). It has been described in very few case reports.Purpose and Methods: We encountered OP in three patients with SLE in 1 year; two manifested OP as an initial presentation of SLE, while the third manifested OP when SLE relapsed. To elucidate the clinical features and outcomes of OP in patients with SLE, we screened the PubMed database for cases diagnosed with OP either at or after the diagnosis of SLE; the search was restricted to articles that were published after 1990, when OP became widely recognized.Results: We identified 15 cases of OP in patients with SLE. Thus, we analyzed a total of 18 cases (including our three). OP developed at the initial diagnosis of SLE in 15 cases and at relapse of SLE in three cases. In most cases, the disease activity of SLE was moderate or high. In all cases, OP was accompanied by other extrapulmonary symptoms of SLE, namely, fever (77.8%), cutaneous manifestations (61.1%), arthralgia/arthritis (50%), and lupus nephritis (33.3%). Steroid monotherapy or increasing the dose of the steroids was effective in seven cases (38.8%); however, steroid monotherapy was ineffective and led to death due to respiratory failure in two cases (11.1%). Combination therapies of steroids with hydroxychloroquine, azathioprine, tacrolimus, mycophenolate mofetil, intravenous pulse cyclophosphamide therapy, and belimumab were effective in seven cases (38.8%).Conclusions: Based on the review of previously reported and our cases, we concluded that OP is an important pulmonary manifestation of SLE. Clinicians should be aware of it as it may require intensive immunosuppressive therapy either at or after the diagnosis of SLE.
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Affiliation(s)
- Yuhei Ito
- Center for Rheumatic Diseases, 220937Mie University Hospital, Tsu, Japan
| | - Tatsuya Tamada
- Center for Rheumatic Diseases, 220937Mie University Hospital, Tsu, Japan
| | - Yuki Okunishi
- Center for Rheumatic Diseases, 220937Mie University Hospital, Tsu, Japan
| | - Satoshi Mizutani
- Center for Rheumatic Diseases, 220937Mie University Hospital, Tsu, Japan
| | - Yoshiki Yamamoto
- Center for Rheumatic Diseases, 220937Mie University Hospital, Tsu, Japan
| | - Ayako Nakajima
- Center for Rheumatic Diseases, 220937Mie University Hospital, Tsu, Japan
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Wang Y, Xie X, Zheng S, Du G, Chen S, Zhang W, Zhuang J, Lin J, Hu S, Zheng K, Mikish A, Xu Z, Zhang G, Gargani L, Bruni C, Hoffmann-Vold AM, Matucci-Cerinic M, Furst DE. Serum B-cell activating factor and lung ultrasound B-lines in connective tissue disease related interstitial lung disease. Front Med (Lausanne) 2022; 9:1066111. [PMID: 36590969 PMCID: PMC9798453 DOI: 10.3389/fmed.2022.1066111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 11/24/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To investigate the role of serum B-cell activating factor (BAFF) and lung ultrasound (LUS) B-lines in connective tissue disease related interstitial lung disease (CTD-ILD), and their association with different ILD patterns on high resolution computed tomography (HRCT) of chest. METHODS We measured the levels of BAFF and KL-6 by ELISA in the sera of 63 CTD-ILD patients [26 with fibrotic ILD (F-ILD), 37 with non-fibrotic ILD (NF-ILD)], 30 CTD patients without ILD, and 26 healthy controls. All patients underwent chest HRCT and LUS examination. RESULTS Serum BAFF levels were significantly higher in CTD patients compared to healthy subjects (617.6 ± 288.1 pg/ml vs. 269.0 ± 60.4 pg/ml, p < 0.01). BAFF concentrations were significantly different between ILD group and non-ILD group (698.3 ± 627.4 pg/ml vs. 448.3 ± 188.6 pg/ml, p < 0.01). In patients with ILD, BAFF concentrations were significantly correlated with B-lines number (r = 0.37, 95% CI 0.13-0.56, p < 0.01), KL-6 level (r = 0.26, 95% CI 0.01-0.48, p < 0.05), and Warrick score (r = 0.33, 95% CI 0.09-0.53, p < 0.01), although all correlations were only low to moderate. B-lines number correlated with Warrick score (r = 0.65, 95% CI 0.48-0.78, p < 0.01), and KL-6 levels (r = 0.43, 95% CI 0.21-0.61, p < 0.01). Patients with F-ILD had higher serum BAFF concentrations (957.5 ± 811.0 pg/ml vs. 516.1 ± 357.5 pg/ml, p < 0.05), KL-6 levels (750.7 ± 759.0 U/ml vs. 432.5 ± 277.5 U/ml, p < 0.05), B-lines numbers (174.1 ± 82 vs. 52.3 ± 57.5, p < 0.01), and Warrick score (19.9 ± 4.6 vs. 13.6 ± 3.4, p < 0.01) vs. NF-ILD patients. The best cut-off values to separate F-ILD from NF-ILD using ROC curves were 408 pg/ml for BAFF (AUC = 0.73, p < 0.01), 367 U/ml for KL-6 (AUC = 0.72, p < 0.05), 122 for B-lines number (AUC = 0.89, p < 0.01), and 14 for Warrick score (AUC = 0.87, p < 0.01) respectively. CONCLUSION Serum BAFF levels and LUS B-lines number could be useful supportive biomarkers for detecting and evaluating the severity and/or subsets of CTD-ILD. If corroborated, combining imaging, serological, and sonographic biomarkers might be beneficial and comprehensive in management of CTD-ILD.
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Affiliation(s)
- Yukai Wang
- Department of Rheumatology and Immunology, Shantou Central Hospital, Shantou, Guangdong, China
- *Correspondence: Yukai Wang,
| | - Xuezhen Xie
- Department of Rheumatology and Immunology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Shaoyu Zheng
- Department of Rheumatology and Immunology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Guangzhou Du
- Department of Radiology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Shaoqi Chen
- Department of Ultrasound, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
- Shaoqi Chen,
| | - Weijin Zhang
- Department of Rheumatology and Immunology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Jinghua Zhuang
- Department of Rheumatology and Immunology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Jianqun Lin
- Department of Rheumatology and Immunology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Shijian Hu
- Department of Rheumatology and Immunology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Kedi Zheng
- Department of Rheumatology and Immunology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Angelina Mikish
- Department of Rheumatology and Immunology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Zhuangyong Xu
- Department of Radiology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Guohong Zhang
- Department of Pathology, Shantou University Medical College, Shantou, Guangdong, China
| | - Luna Gargani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Cosimo Bruni
- Division of Rheumatology, Department of Experimental and Clinical Medicine, Careggi University Hospital, University of Florence, Florence, Italy
| | | | - Marco Matucci-Cerinic
- Division of Rheumatology, Department of Experimental and Clinical Medicine, Careggi University Hospital, University of Florence, Florence, Italy
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Hospital, Milan, Italy
| | - Daniel E. Furst
- Division of Rheumatology, Department of Experimental and Clinical Medicine, Careggi University Hospital, University of Florence, Florence, Italy
- Division of Rheumatology, Department of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Medicine, University of Washington, Seattle, WA, United States
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Yu G, Ji H, Meng C, Huang Y, Gao G, Liu C, Wang S, Zhang L, Ju J. Surgical management of organizing pneumonia: a retrospective study of 24 cases in a single Centre. J Cardiothorac Surg 2019; 14:122. [PMID: 31253173 PMCID: PMC6599375 DOI: 10.1186/s13019-019-0939-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Accepted: 06/17/2019] [Indexed: 11/29/2022] Open
Abstract
Background Organizing pneumonia (OP) is a rare disease that is often easily misdiagnosed as a malignancy. The diagnosis of OP can prove quite challenging. Patients typically receive treatment with high-dose corticosteroids. Relapse is common if corticosteroid treatment is reduced or stopped. However, given that long-term corticosteroid treatment often results in significant side-effects, the aim of this study was to discuss the diagnosis and surgical treatment of OP. Material and methods The medical records of 24 patients with pathologically diagnosed OP between October 2007 and January 2019 were retrospectively reviewed. All patients underwent thoracic computed tomography (CT) and transbronchial biopsy or CT-guided percutaneous needle aspiration. We analysed the clinical manifestations, radiological findings, diagnostic methods, treatment, and follow-up outcomes of all patients. Results In total, 24 patients with OP were identified. The study included 17 (70.8%) men and 7 (29.2%) women, and the mean age was 61.25 ± 11.33 years (range: 31–82). The most common symptom was cough (n = 16; 66.6%), and the most common radiological finding was consolidation (n = 13; 54.2%) on thoracic CT. The diagnosis of OP was made by transbronchial biopsy in 11 patients (45.8%), and percutaneous needle aspiration biopsy in 13 (54.2%). We performed 11 wedge resections, 9 segmentectomy, and 4 lobectomies. Twenty patients underwent video-assisted thoracoscopic surgery (VATS), and 4 underwent thoracotomy. Complete lesion resection was obtained in all patients, and all patients were discharged from the hospital between 5 and 11 days after surgery. The mean follow-up period was 59.1 ± 34.5 (range: 2–134) months. Residual lesions or local or distant recurrence were not observed. Conclusions OP is a rare disease, and the exact aetiology remains unclear. Preoperative diagnosis is difficult to achieve despite the use of transbronchial biopsy or CT-guided percutaneous needle aspiration. Complete surgical resection represents an effective method for the treatment of OP.
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Affiliation(s)
- Ge Yu
- Department of Thoracic Surgery, Weihai Municipal Hospital, 70 Heping Road, Weihai, 264200, Shandong, China
| | - Huaijun Ji
- Department of Thoracic Surgery, Weihai Municipal Hospital, 70 Heping Road, Weihai, 264200, Shandong, China.
| | - Chuizheng Meng
- Department of Thoracic Surgery, Weihai Municipal Hospital, 70 Heping Road, Weihai, 264200, Shandong, China
| | - Yixuan Huang
- Department of Thoracic Surgery, Weihai Municipal Hospital, 70 Heping Road, Weihai, 264200, Shandong, China
| | - Guogang Gao
- Department of Thoracic Surgery, Weihai Municipal Hospital, 70 Heping Road, Weihai, 264200, Shandong, China
| | - Chuanping Liu
- Department of Thoracic Surgery, Weihai Municipal Hospital, 70 Heping Road, Weihai, 264200, Shandong, China
| | - Shanlei Wang
- Department of Thoracic Surgery, Weihai Municipal Hospital, 70 Heping Road, Weihai, 264200, Shandong, China
| | - Lei Zhang
- Department of Thoracic Surgery, Weihai Municipal Hospital, 70 Heping Road, Weihai, 264200, Shandong, China
| | - Jin Ju
- Department of Thoracic Surgery, Weihai Municipal Hospital, 70 Heping Road, Weihai, 264200, Shandong, China.
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