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Author: search.filters.author.Cristina Drenkard

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    Item type:Publication,
    First Latin American clinical practice guidelines for the treatment of systemic lupus erythematosus: Latin American Group for the Study of Lupus (GLADEL, <i>Grupo Latino Americano de Estudio del Lupus</i>)–Pan-American League of Associations of Rheumatology (PANLAR)
    (2018)
    Bernardo A Pons-Estel
    ;
    Eloisa Bonfa
    ;
    Enrique R Soriano
    ;
    Mario H Cardiel
    ;
    Ariel Izcovich
    <jats:p>Systemic lupus erythematosus (SLE), a complex and heterogeneous autoimmune disease, represents a significant challenge for both diagnosis and treatment. Patients with SLE in Latin America face special problems that should be considered when therapeutic guidelines are developed. The objective of the study is to develop clinical practice guidelines for Latin American patients with lupus. Two independent teams (rheumatologists with experience in lupus management and methodologists) had an initial meeting in Panama City, Panama, in April 2016. They selected a list of questions for the clinical problems most commonly seen in Latin American patients with SLE. These were addressed with the best available evidence and summarised in a standardised format following the Grading of Recommendations Assessment, Development and Evaluation approach. All preliminary findings were discussed in a second face-to-face meeting in Washington, DC, in November 2016. As a result, nine organ/system sections are presented with the main findings; an ‘overarching’ treatment approach was added. Special emphasis was made on regional implementation issues. Best pharmacologic options were examined for musculoskeletal, mucocutaneous, kidney, cardiac, pulmonary, neuropsychiatric, haematological manifestations and the antiphospholipid syndrome. The roles of main therapeutic options (ie, glucocorticoids, antimalarials, immunosuppressant agents, therapeutic plasma exchange, belimumab, rituximab, abatacept, low-dose aspirin and anticoagulants) were summarised in each section. In all cases, benefits and harms, certainty of the evidence, values and preferences, feasibility, acceptability and equity issues were considered to produce a recommendation with special focus on ethnic and socioeconomic aspects. Guidelines for Latin American patients with lupus have been developed and could be used in similar settings.</jats:p>
    Scopus© Citations 88  7
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    Factors associated with neuropsychiatric involvement in Latin American patients with systemic lupus erythematosus
    (2021)
    Leonor A Barile-Fabris
    ;
    Hilda Fragoso-Loyo
    ;
    Daniel Wojdyla
    ;
    Rosana Quintana
    ;
    Guillermo J Pons-Estel
    <jats:sec><jats:title>Introduction</jats:title><jats:p> Factors related to presentation of neuropsychiatric (NP) SLE manifestations, early in the course of the disease, and during follow up have not been clearly established. </jats:p></jats:sec><jats:sec><jats:title>Purpose</jats:title><jats:p> To identify disease and non-disease related factors associated with NP manifestations in early SLE. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> We included 1193 patients from the GLADEL inception cohort free of NP involvement at cohort entry. We evaluated the association of demographic, clinical and laboratory data with NP involvement during follow-up. </jats:p></jats:sec><jats:sec><jats:title>Statistical methods</jats:title><jats:p> Independent factors associated with NP involvement were identified using a multivariable Cox regression model. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> Factors independently associated with NP manifestations were: mestizo ethnicity (HR 1.701, 95% CI 1.282–2.258, p = 0.0002), myalgias/myositis (HR 1.832, 95% CI 1.335–2.515, p = 0.0002), pneumonitis (HR 2.476, 95% CI 1.085–5.648, p = 0.0312), shrinking lung (HR 2.428, 95% CI 1.074–5.493, p = 0.0331) and hemolytic anemia (HR 1.629, 95% CI 1.130–2.347, p = 0.0089). Longer disease duration at cohort entry (13 to 24 months) was associated with a lower risk of developing NP manifestations (HR 0.642, 95% CI 0.441–0.934, p = 0.0206). </jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p> Patients with myalgias/myositis, pneumonitis, shrinking lung and hemolytic anemia are at higher risk of NP involvement, whereas longer disease duration at cohort entry is associated with a lower risk of developing NP involvement. </jats:p></jats:sec>
      15Scopus© Citations 3