Systemic lupus erythematosus. Measures to keep this unpredictable disease under control

Serum leucine-rich α2-glycoprotein is elevated in patients with systemic lupus erythematosus and correlates with disease activity

BACKGROUND

We evaluated whether serum leucine-rich α2-glycoprotein (LRG) is associated with disease activity in patients with systemic lupus erythematosus (SLE).

METHODS

We measured serum LRG in 194 SLE patients. SLE disease activity index-2000 (SLEDAI-2 K) was used to assess SLE activity, and patients with SLEDAI-2 K ≥5 were defined as having active SLE. Correlation between serum LRG, SLEDAI-2 K, and laboratory variables was estimated by Pearson's correlation analysis. The optimal serum LRG cut-off value for predicting active SLE was calculated using receiver operator characteristic (ROC) curve, and multivariable logistic regression was used to determine the odds ratio (OR) of laboratory variables.

RESULTS

In total, 74 (38.1%) and 120 (61.9%) patients were classified as active and inactive SLE, respectively. Serum LRG was higher in patients with active SLE than in inactive SLE and healthy controls (26.6 vs. 14.4 vs. 1.2 ng/ml, p < .001). Serum LRG significantly correlated with SLEDAI-2 K (r = 0.340, p < .001) and laboratory variables. ROC analysis revealed that optimal serum LRG cut-off value for active SLE was >45.7 ng/ml. In multivariable logistic regression analysis, serum LRG >45.7 ng/ml (OR 4.089, 95% confidence interval 1.351, 12.376, p = .013) was an independent predictor of active SLE.

CONCLUSIONS

Serum LRG might be a biomarker for estimating SLE disease activity.

Individuals living with lupus: findings from the LUPUS UK Members Survey 2014

Systemic lupus erythematosus (SLE) is a complex and unpredictable disease which varies greatly among patients and has a significant impact on an individual’s daily living and quality of life. A better understanding of the patients’ experiences with the disease is vital to the effective management of the disease. LUPUS UK, a national UK-registered charity supporting people with systemic and discoid lupus, conducted a UK-wide survey of individuals living with lupus in order to provide foundation information to support and identify gaps needing further research.

An anonymous survey was sent to 5660 LUPUS UK members in order to obtain demographic, diagnosis, symptom and treatment information. A total of 2527 surveys were returned by 2371 females (mean age 56.9 years, SD 13.6) and 156 males, (mean age 60.9 years, SD 15.7). Individuals reported a mean (SD) time to diagnosis from the first symptom of 6.4 (9.5) years, with 47% (n = 1186) initially being given a different diagnosis prior to lupus. Fatigue/weakness (91%, n = 2299) and joint pain/swelling (77.4%, n = 1957) were the most common symptoms that interfere with daily activities, while 73% (n = 1836) noted having some problems that make them unable to carry out their usual daily activities. Thirty-two per cent (n = 806) were also seeking support beyond traditional pharmacological treatments, such as acupuncture and massage. This study highlights the range and frequency of symptoms difficult to live with on a daily basis and support areas needing further research to improve patients’ well-being.