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Systemic Lupus Erythematosus: Management, Complications and Future Opportunities
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Systemic Lupus Erythematosus: Management, Complications and Future Opportunities

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Immunology".

Deadline for manuscript submissions: closed (15 March 2024) | Viewed by 2543

Special Issue Editors

Dr. Nikolaos Koletsos

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Guest Editor
Rheumatology Clinic, Department of Internal Medicine, Medical School, University Hospital of Ioannina, 45500 Ioannina, Greece
Interests: clinical rheumatology; rheumatic diseases; autoimmune disease, microcirculation; macrocirculation
Dr. Evripidis Kaltsonoudis

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Guest Editor
Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, 45110 Ioannina, Greece
Interests: clinical rheumatology; rheumatic diseases; rheumatoid arthritis; TNF

Special Issue Information

Dear Colleagues,

Systemic lupus erythematosus (SLE) is a prototype autoimmune disease. It is characterized by a variety of manifestations and can affect any organ with different degrees of severity. Diagnosis can be challenging and, despite the marked improvements in SLE therapeutics during recent decades, the disease still has increased mortality compared to the general population. Many patients, also, experience complications from organ damage. Moreover, comorbidities are often present, complicating the disease course and resulting in a reduction in quality of life. Therefore, SLE continues to be a challenging disease. 

This Special Issue is focused on, but not limited to, current and new knowledge on the diagnostic tools, clinical manifestations, target organ damage complications, comorbidities, therapeutic strategies, as well as future perspectives in SLE.

We hope this article collection will provide an updated overview of the field and we look forward to your contributions.

Yours faithfully,

Dr. Nikolaos Koletsos
Dr. Evripidis Kaltsonoudis
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • systemic lupus erythematosus
  • diagnosis
  • clinical features
  • complications
  • target organ damage
  • comorbidities
  • therapeutic strategies
  • treatments
  • unmet needs

Published Papers (2 papers)

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Research

14 pages, 852 KiB  
Article
Accumulation of Microvascular Target Organ Damage in Systemic Lupus Erythematosus Patients Is Associated with Increased Cardiovascular Risk
by Nikolaos Koletsos, Antonios Lazaridis, Areti Triantafyllou, Panagiota Anyfanti, Stamatina Lamprou, Anastasia Stoimeni, Nikolaos G. Papadopoulos, Evaggelia-Evdoxia Koravou and Eugenia Gkaliagkousi
J. Clin. Med. 2024, 13(7), 2140; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm13072140 - 8 Apr 2024
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Abstract
Background: Systemic lupus erythematosus (SLE) is a prototype autoimmune disease associated with increased cardiovascular (CV) burden. Besides increased arterial stiffness and subclinical atherosclerosis, microvascular dysfunction is considered an important component in the pathophysiology of CV disease. However, there is a lack of [...] Read more.
Background: Systemic lupus erythematosus (SLE) is a prototype autoimmune disease associated with increased cardiovascular (CV) burden. Besides increased arterial stiffness and subclinical atherosclerosis, microvascular dysfunction is considered an important component in the pathophysiology of CV disease. However, there is a lack of data regarding the effect of multiple target organ damage (TOD) on CV health. Objectives: This study aimed to evaluate (i) the presence of microvascular changes in SLE in various vascular beds, (ii) the possible associations between the accumulation of microvascular TOD and CV risk and (iii) whether Galectin-3 represents a predictor of combined microvascular TOD. Methods: Participants underwent (i) evaluation of skin microvascular perfusion (laser speckle contrast analysis), (ii) fundoscopy (non-mydriatic fundus camera), (iii) indirect assessment of myocardial perfusion (subendocardial viability ratio) and (iv) determination of urine albumin-to-creatinine ratio (UACR). CV risk was calculated using the QResearch Risk Estimator version 3 (QRISK3). Serum Galectin-3 levels were determined. Results: Forty-seven SLE patients and fifty controls were studied. SLE patients demonstrated impaired skin microvascular reactivity (160.2 ± 41.0 vs. 203.6 ± 40.1%), retinal arteriolar narrowing (88.1 ± 11.1 vs. 94.6 ± 13.5 μm) and higher UACR levels compared to controls. Furthermore, SLE individuals had significantly higher Galectin-3 levels [21.5(6.1) vs. 6.6(6.6) ng/dL], QRISK3 scores [7.0(8.6) vs. 1.3(3.6)%] and a greater chance for microvascular dysfunction. In the SLE group, patients with multiple TOD exhibited higher QRISK3. In the multivariate analysis, the accumulation of TOD correlated with disease activity and Galectin-3 (p < 0.05). Conclusions: Our study showed for the first time that SLE patients exhibit a greater number of cases of TOD. The accumulation of TOD was associated with increased CV risk. Clinicians dealing with SLE should be aware and seek microvascular alterations. Full article
(This article belongs to the Special Issue Systemic Lupus Erythematosus: Management, Complications and Future Opportunities)
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13 pages, 2891 KiB  
Article
Real-World Effectiveness of Belimumab in Patients with Active Lupus
by Yuya Sumichika, Shuhei Yoshida, Eiji Suzuki, Kenji Saito, Haruki Matsumoto, Jumpei Temmoku, Yuya Fujita, Naoki Matsuoka, Tomoyuki Asano, Shuzo Sato and Kiyoshi Migita
J. Clin. Med. 2023, 12(24), 7627; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12247627 - 11 Dec 2023
Cited by 1 | Viewed by 1773
Abstract
This study evaluated the real-world effectiveness of belimumab (BLM) in the treatment of systemic lupus erythematosus (SLE) patients with moderate to high disease activity. This retrospective cohort study enrolled 129 Japanese patients with moderate to high SLE disease activity who received BLM between [...] Read more.
This study evaluated the real-world effectiveness of belimumab (BLM) in the treatment of systemic lupus erythematosus (SLE) patients with moderate to high disease activity. This retrospective cohort study enrolled 129 Japanese patients with moderate to high SLE disease activity who received BLM between January 2013 and March 2023. The clinical outcomes, including the flare-free survival, SLE Disease Activity Index 2000 (SLEDAI-2K) score, and prednisone-equivalent dose, in the BLM and mycophenolate mofetil (MMF) treatment groups were compared before and after treatment. Safety data for BLM were collected. Additionally, we compared the effectiveness of BLM and intravenous cyclophosphamide (IV-CY) treatment using the stabilized inverse probability of treatment weighting (IPTW) method based on the propensity scores. This observational study enrolled 129 patients with moderate/severe SLE: 48 patients received belimumab, 45 received IV-CY, and 36 received MMF and prednisolone for remission induction therapy. The median follow-up for the BLM group was 17.0 months. Among them, 19 received BLM plus MMF. BLM significantly reduced the mean SLEDAI-2K (from mean baseline to 52 weeks: 49.2% reduction from 12.8 to 6.5) and prednisone daily dose (from mean baseline to 52 weeks: 21.9% reduction from 12.8 to 10.0 mg/day). The flare-free survival at 52 weeks was not significantly different between the BLM and MMF groups. There was no significant difference in the flare-free survival rates or reduction rates of the SLEDAI-2K between the patients treated with BLM and those treated with BLM plus MMF. In the propensity score-matched comparative analyses, there was no significant difference in the flare-free survival rates or an estimated decline in the SLEDAI-2K scores between the patients with lupus treated with BLM and IV-CY. BLM may be a promising alternative treatment option for lupus patients with moderate or high disease activity who do not respond to conventional treatments. Full article
(This article belongs to the Special Issue Systemic Lupus Erythematosus: Management, Complications and Future Opportunities)
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