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Systemic Lupus Erythematosus
SLE ,[object Object],[object Object]
Median age of disease onset ,[object Object],[object Object],[object Object]
Mortality 10 year survival rate
SLE- Emerging therapies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SLE ,[object Object]
Prevalence of SLE in South London ,[object Object],[object Object],[object Object],[object Object],[object Object]
What is Lupus? ,[object Object],[object Object],[object Object],[object Object],[object Object]
Classification criteria (  4 of 11) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],American College of  Rheumatology  The 1982 revised criteria for  classification of systemic  lupus erythematosus
Classification criteria (  4 of 11) ,[object Object],[object Object],[object Object],American College of Rheumatology  The 1982 revised criteria for classification of systemic  lupus erythematosus
Classification criteria (  4 of 11) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classification criteria (  4 of 11) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classification criteria (  4 of 11) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Erythematous raised patches with adherent keratotic scaling and follicular  plugging; atrophic scarring may occur  in older lesions
Classification criteria (  4 of 11) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classification criteria (  4 of 11) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classification criteria (  4 of 11) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Nonerosive arthritis involving 2  or more peripheral joints,  characterized by tenderness,  swelling, or effusion
Classification criteria (  4 of 11) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classification criteria (  4 of 11) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Lupus Nephritis ,[object Object],[object Object],[object Object],[object Object]
Glomerulonephritis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classification criteria (  4 of 11) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Neurological manifestations ,[object Object],[object Object]
Neurological manifestations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classification criteria (  4 of 11) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Haematological ,[object Object],[object Object],[object Object],[object Object]
Classification criteria (  4 of 11) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classification criteria (  4 of 11) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Anti-Double stranded DNA ,[object Object],[object Object],[object Object],[object Object]
Anti-Smith (Anti-Sm) ,[object Object],[object Object],[object Object],[object Object]
Anti-cardiolipin and Lupus anticoagulant ,[object Object],[object Object],[object Object]
General features ,[object Object],[object Object],[object Object],[object Object],[object Object]
Laboratory features ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Extractable nuclear antigens -ENA ,[object Object],[object Object],[object Object],[object Object]
Management ,[object Object],[object Object],[object Object]
Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Hydroxychoroquine ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Hydroxychoroquine-Toxicity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Hydroxychoroquine- Retinal toxicity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Hydroxychoroquine ,[object Object],[object Object],[object Object],[object Object],[object Object]
Effect of prednisone and hydroxychloroquine on coronary artery disease risk factors in systemic lupus erythematosus: a longitudinal data analysis. ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
Immunosuppressants ,[object Object],[object Object],[object Object],[object Object]
Cyclophosphamide ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cyclophosphamide Side effects ,[object Object],[object Object],[object Object],[object Object],[object Object]
Randomized study of maintenance Rx Cyclo, azathioprine and MMF Contreras, G. et al. N Engl J Med 2004;350:971-980
Randomized study of maintenance Rx Cyclo, azathioprine and MMF Contreras, G. et al. N Engl J Med 2004;350:971-980 Kaplan-Meier Estimates of Relapse-free Survival
Induction therapy: Mycophenolate Mofetil Vs Cyclophosphamide Chan, T. M. et al. N Engl J Med 2000;343:1156-1162 Outcome of Treatment Chan, T. M. et al. N Engl J Med 2000;343:1156-1162
Chan, T. M. et al. N Engl J Med 2000;343:1156-1162 Mean ({+/-}SD) Serum Albumin Concentration and Urinary Protein Excretion in Patients with Diffuse Proliferative Lupus Nephritis Who Were Treated with Mycophenolate Mofetil and Prednisolone (Group 1) or with Cyclophosphamide and Prednisolone Followed by Azathioprine and Prednisolone (Group 2)
Long-Term Study of Mycophenolate Mofetil as Continuous Induction and Maintenance Treatment for Diffuse Proliferative Lupus Nephritis. Chan TM, Tse KC, Siu-On Tang C, Mok MY, Li FK. J Am Soc Nephrol. 2005 Feb 23   ,[object Object],[object Object],[object Object],[object Object]
Long-Term Study of Mycophenolate Mofetil as Continuous Induction and Maintenance Treatment for Diffuse Proliferative Lupus Nephritis. Chan TM, Tse KC, Siu-On Tang C, Mok MY, Li FK. J Am Soc Nephrol. 2005 Feb 23   ,[object Object],[object Object],[object Object],[object Object],[object Object]
Mycophenolate Mofetil ,[object Object],[object Object],[object Object],[object Object],[object Object]
Mycophenolate Mofetil  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Azathioprine ,[object Object],[object Object],[object Object],[object Object]
Anti-CD20 therapy Rituximab ,[object Object],[object Object],[object Object],[object Object],[object Object]
Rituximab ,[object Object],[object Object]
 
B-Cell Characteristics ,[object Object],[object Object],[object Object],[object Object],[object Object]
Rituximab in SLE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Leandro et al  ACR 2004 Abs1126   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Leandro et al  ACR 2004 Abs1126 ,[object Object],[object Object],[object Object],[object Object]
Leandro et al  ACR 2004 Abs1126 ,[object Object],[object Object],[object Object]
Leandro et al  ACR 2004 Abs1126 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Leandro et al  ACR 2004 Abs1126 ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
Looney et al  Arthritis Rheum. 2004;50:2580-9 ,[object Object],[object Object],[object Object],[object Object],[object Object]
Looney et al  Arthritis Rheum. 2004;50:2580-9 ,[object Object],[object Object],[object Object],[object Object],[object Object]
Looney et al  Arthritis Rheum. 2004;50:2580-9 ,[object Object],[object Object],[object Object],[object Object],[object Object]
Looney et al  Arthritis Rheum. 2004;50:2580-9 ,[object Object],[object Object]
Cyclophosphamide and Rituximab ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cyclophosphamide and Rituximab ,[object Object],[object Object],[object Object],[object Object]
Rituximab ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Rituximab ,[object Object],[object Object]
Sponsored by Arthritis Research Campaign SEcond Line Agents in Myositis
TRIAL DESIGN: ,[object Object],[object Object],[object Object],[object Object],[object Object]
INCLUSION CRITERIA ,[object Object],[object Object],[object Object],[object Object]

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S Lecture

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  • 45. Randomized study of maintenance Rx Cyclo, azathioprine and MMF Contreras, G. et al. N Engl J Med 2004;350:971-980
  • 46. Randomized study of maintenance Rx Cyclo, azathioprine and MMF Contreras, G. et al. N Engl J Med 2004;350:971-980 Kaplan-Meier Estimates of Relapse-free Survival
  • 47. Induction therapy: Mycophenolate Mofetil Vs Cyclophosphamide Chan, T. M. et al. N Engl J Med 2000;343:1156-1162 Outcome of Treatment Chan, T. M. et al. N Engl J Med 2000;343:1156-1162
  • 48. Chan, T. M. et al. N Engl J Med 2000;343:1156-1162 Mean ({+/-}SD) Serum Albumin Concentration and Urinary Protein Excretion in Patients with Diffuse Proliferative Lupus Nephritis Who Were Treated with Mycophenolate Mofetil and Prednisolone (Group 1) or with Cyclophosphamide and Prednisolone Followed by Azathioprine and Prednisolone (Group 2)
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  • 74. Sponsored by Arthritis Research Campaign SEcond Line Agents in Myositis
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Editor's Notes

  1. Figure 3. Kaplan-Meier Estimates of Relapse-free Survival.
  2. Table 3. Outcome of Treatment.
  3. Figure 2. Mean ({+/-}SD) Serum Albumin Concentration and Urinary Protein Excretion in Patients with Diffuse Proliferative Lupus Nephritis Who Were Treated with Mycophenolate Mofetil and Prednisolone (Group 1) or with Cyclophosphamide and Prednisolone Followed by Azathioprine and Prednisolone (Group 2). The mean serum albumin concentration was significantly higher than the base-line value after two weeks of therapy in group 2 and after four weeks of therapy in group 1, and it remained significantly higher at each subsequent evaluation (P<0.05 for the comparisons in each group). Urinary protein excretion was significantly lower than the base-line value after two weeks of therapy in group 1 and after four weeks of therapy in group 2, and it remained significantly lower at each subsequent evaluation (P<0.05 for the comparisons in each group). The numbers below the panels are numbers of patients for whom data were available.