Advanced Handbook of Systemic Lupus Erythematosus (eBook)

Laurent Arnaud, Ronald Van Vollenhoven (Autoren)

eBook Download: PDF

2017 | 1. Auflage
179 Seiten
Adis (Verlag)
978-3-319-43035-5 (ISBN)

Infos

This book will provide an introduction to the epidemiology, etiology and pathogenesis of the condition while also exploring the classification, diagnosis, and current and emerging therapies for systemic lupus erythematosus. Systemic lupus erythematosus is an autoimmune disease in which the body's immune system mistakenly attacks healthy tissue. It can affect the skin, joints, kidneys, brain, and other organs. The underlying cause of the disease is not fully known, and SLE is much more common in women than in men. It may occur at any age but most often occurs in people between 10 and 50 years of age. This is the second Adis title from Ronald F van Vollenhoven, who previously authored Biologics for the Treatment of Rheumatoid Arthritis.

Professor Ronald F van Vollenhoven is Chief of the Unit for Clinical Therapy Research, Inflammatory Diseases (ClinTRID) at the Karolinska Institute, and of the Clinical Trials Unit Rheumatology at the Karolinska University Hospital. He received his MD and PhD degrees from the University of Leiden in The Netherlands. After graduating in 1984 he pursued immunology research at Cornell Medical College in New York, followed by a residency (specialty training) in internal medicine at the State University of New York at Stony Brook, and a fellowship in rheumatology at Stanford University in Palo Alto following which he received American Board of Internal Medicine certification in both internal medicine and rheumatology. From 1993 to 1998 Professor van Vollenhoven held a faculty appointment as Assistant Professor of Medicine in the Division of Immunology and Rheumatology at Stanford University, and from 1995 he was the Medical Services Chief and Fellowship Director in that division. In 1998 Professor van Vollenhoven moved to Stockholm, Sweden, where he worked as a Senior Physician and Chief of the Clinical Trials Unit in the Department of Rheumatology at the Karolinska University Hospital and Associate Professor of Rheumatology; and in 2010, he was appointed in his current position as Professor and Unit Chief at the Karolinska Institute. Professor van Vollenhoven's research interests focus around the development and systematic evaluation of biologic and immunomodulatory treatments for the rheumatic diseases. With his co-workers, he has established the Stockholm registry for biological therapies (the STURE database) for this purpose, which has supported research projects relating to clinical efficacy, pharmacology, outcomes, and pharmacoeconomics. He has been principal investigator in many clinical trials of novel therapies in rheumatic diseases and has contributed to a number of important investigator-initiated trials including the SWEFOT trial. He has published over 300 original papers, book chapters and reviews, and is Editor of the textbook Targeted Treatment of the Rheumatic Diseases and associate-editor of Dubois' Lupus Erythematosus. In 2004, Professor van Vollenhoven was awarded the Scandinavian Research Foundation Prize for excellence in clinical research in rheumatology, and he is an honorary member of several rheumatology societies. He is the Editor-in-Chief of Lupus Science & Medicine, Chair of the EULAR Standing Committee on Clinical Affairs, member of many editorial boards, past-chair of the Swedish Rheumatology Society Professors' Council, co-founder of the IRBIS registry for biologics in systemic lupus erythematosus (SLE), the CERERRA registries collaboration, and the NORD-STAR collaboration for Nordic trials in the rheumatic diseases, and the initiator of the Treat-to-Target-in-SLE initiative. Professor van Vollenhoven lives just north of Stockholm with his wife and children aged 22 and 18. Outside his professional life he is an avid classical pianist. 

Inhalt

Contents 5
Author biographies 8
Abbreviations 11
1 Introduction 15
1.1 Disease overview 15
1.2 Epidemiology 18
1.2.1 Incidence 18
1.2.2 Prevalence 19
1.3 Etiology and pathogenesis 20
1.4 Genetic susceptibility 22
1.4.1 Human leukocyte antigens 22
1.4.2 Complement deficiencies 22
1.4.3 Monogenic systemic lupus erythematosus and interferonopathies 25
1.5 Environmental factors 27
1.5.1 UV light 27
1.5.2 Tobacco 28
1.5.3 Silica 28
1.5.4 Solvents 28
1.5.5 Infections 28
1.5.6 Other exposures 29
1.6 Hormonal factors 30
1.7 Drug-induced systemic lupus erythematosus 31
References 34
2Disease classification 41
2.1 Historical development 41
2.2 Classification criteria 42
2.3 The American College of Rheumatology classification criteria for systemic lupus erythematosus 42
2.4 Limitations of the American College of Rheumatology classification criteria for systemic lupus erythematosus 46
2.5 The Systemic Lupus International Collaborative Clinics classification criteria for systemic lupus erythematosus 47
2.6 Sub-classification of systemic lupus erythematosus 51
References 51
3Disease manifestations 52
3.1 Overview 52
3.2 Constitutional 54
3.3 Musculoskeletal 55
3.4 Dermatologic 57
3.4.1 Histopathology of cutaneous lupus erythematosus 57
3.4.2 Acute cutaneous lupus erythematosus 57
3.4.3 Subacute cutaneous lupus erythematosus 58
3.4.4 Chronic cutaneous lupus 58
3.4.5 Bullous lesions 60
3.4.6 Assessment of cutaneous activity 61
3.5 Renal lupus 62
3.6 Neuropsychiatric 64
3.7 Cardiac manifestations 67
3.8 Pulmonary 69
3.9 Gastrointestinal 71
3.10 Hematological 72
3.11 Ocular manifestations 75
References 76
4Diagnosis 84
4.1 Clinical assessment 84
4.2 Laboratory testing 85
4.2.1 Antinuclear antibodies 85
4.2.2 Anti-dsDNA, anti-histone and anti-nucleosome antibodies 87
4.2.3 Anti-ENA antibodies 88
4.2.4 Other specificities 88
4.2.5 Complement levels 88
4.2.6 Antiphospholipid antibodies 89
4.2.7 Standard laboratory testing 90
4.3 Imaging 90
4.4 Differential diagnosis 93
References 95
5Treatments 98
5.1 Goals of treatment and treatment strategies 98
5.1.2 Treatment strategies 99
5.2 Local measures and nonsteroidal medications 100
5.3 Antimalarials 101
5.3.1 Hydroxychloroquine 102
5.3.2 Chloroquine 103
5.3.3 Quinacrine 103
5.4 Systemic corticosteroids (glucocorticoids) 104
5.5 Immunosuppressive agents 105
5.5.1 Cyclophosphamide 105
5.5.2 Azathioprine 106
5.5.3 Methotrexate 107
5.5.4 Cyclosporin A 107
5.5.5 Mycophenolate mofetyl 107
5.6 Biologic agents 108
5.6.1 Belimumab (anti-BLyS monoclonal antibody) 108
5.7 Unapproved and experimental therapies 112
5.7.1 Rituximab 112
5.8 Overall treatment principles 113
5.8.1 Treatment of active lupus and lupus flares 113
5.8.2 Chronic treatment of lupus 114
5.8.3 Treatment of lupus nephritis 115
5.9 Adjunctive and preventive measures 117
References 117
6Therapies in late-stage clinical development 121
6.1 Advances in the treatment of systemic lupus erythematosus 121
6.2 B-cell modulating agents 122
6.2.1 B-cell cytokine antagonists 124
6.2.2 B-cell-depleting agents 124
6.2.3 Other B-cell modulating agents 125
6.3 Interferon antagonists 125
6.4 Other investigational agents 127
6.5 Conclusion 127
References 129
7Specific issues 133
7.1 Pediatric systemic lupus erythematosus 133
7.2 Late-onset SLE 137
7.3 Management of pregnancy 140
7.4 Neonatal lupus 144
7.5 Cardiovascular risk 147
7.5.1 Subclinical atherosclerosis 148
7.5.2 Risk of cardiovascular events 148
7.5.3 Traditional cardiovascular risk factors and cardiovascular events 149
7.5.4 Disease activity and cardiovascular events 149
7.5.5 Complications of the disease and cardiovascular events 149
7.5.6 Corticosteroids and cardiovascular events 149
7.5.7 Strategies for assessment of cardiovascular risk in systemic lupus erythematosus patients 150
7.5.8 Prevention of cardiovascular events in systemic lupus erythematosus patients 150
7.6 Infections and vaccines 152
7.6.1 Rate and types of infections 152
7.6.2 Risk factors for infections 152
7.6.3 Diagnostic strategy 153
7.6.4 Infectious agents and vaccines 154
References 155
8Disease activity, outcomes, prognosis, and perspectives 163
8.1 Disease activity 163
8.1.1 Disease activity in individual organ systems 163
8.1.2 Instruments for measuring the overall activity of SLE 166
8.1.3 Other disease activity instruments 171
8.2 Lupus flares 172
8.3 Response to treatment 173
8.4 Remission and low-disease activity 173
8.4.1 Low disease activity 174
8.4.2 Remission 174
8.5 Damage 174
8.6 Patient-reported outcomes and quality of life 175
8.7 Prognosis 176
8.8 Perspectives 177
References 178

Produkt-Details

• Erscheint lt. Verlag: 10.9.2017
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Allgemeinmedizin
• Themenwelt: Studium ► Querschnittsbereiche ► Infektiologie / Immunologie
• ISBN-10: 3-319-43035-1 / 3319430351
• ISBN-13: 978-3-319-43035-5 / 9783319430355