Dataset Information

First Latin American clinical practice guidelines for the treatment of systemic lupus erythematosus: Latin American Group for the Study of Lupus (GLADEL, Grupo Latino Americano de Estudio del Lupus)-Pan-American League of Associations of Rheumatology (PANLAR).

ABSTRACT: 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.

SUBMITTER: Pons-Estel BA

PROVIDER: S-EPMC6225798 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature

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Publications

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).

Pons-Estel Bernardo A BA Bonfa Eloisa E Soriano Enrique R ER Cardiel Mario H MH Izcovich Ariel A Popoff Federico F Criniti Juan M JM Vásquez Gloria G Massardo Loreto L Duarte Margarita M Barile-Fabris Leonor A LA García Mercedes A MA Amigo Mary-Carmen MC Espada Graciela G Catoggio Luis J LJ Sato Emilia Inoue EI Levy Roger A RA Acevedo Vásquez Eduardo M EM Chacón-Díaz Rosa R Galarza-Maldonado Claudio M CM Iglesias Gamarra Antonio J AJ Molina José Fernando JF Neira Oscar O Silva Clóvis A CA Vargas Peña Andrea A Gómez-Puerta José A JA Scolnik Marina M Pons-Estel Guillermo J GJ Ugolini-Lopes Michelle R MR Savio Verónica V Drenkard Cristina C Alvarellos Alejandro J AJ Ugarte-Gil Manuel F MF Babini Alejandra A Cavalcanti André A Cardoso Linhares Fernanda Athayde FA Haye Salinas Maria Jezabel MJ Fuentes-Silva Yurilis J YJ Montandon de Oliveira E Silva Ana Carolina AC Eraso Garnica Ruth M RM Herrera Uribe Sebastián S Gómez-Martín Diana D Robaina Sevrini Ricardo R Quintana Rosana M RM Gordon Sergio S Fragoso-Loyo Hilda H Rosario Violeta V Saurit Verónica V Appenzeller Simone S Dos Reis Neto Edgard Torres ET Cieza Jorge J González Naranjo Luis A LA González Bello Yelitza C YC Collado María Victoria MV Sarano Judith J Retamozo Soledad S Sattler María E ME Gamboa-Cárdenas Rocio V RV Cairoli Ernesto E Conti Silvana M SM Amezcua-Guerra Luis M LM Silveira Luis H LH Borba Eduardo F EF Pera Mariana A MA Alba Moreyra Paula B PB Arturi Valeria V Berbotto Guillermo A GA Gerling Cristian C Gobbi Carla A CA Gervasoni Viviana L VL Scherbarth Hugo R HR Brenol João C Tavares JCT Cavalcanti Fernando F Costallat Lilian T Lavras LTL Da Silva Nilzio A NA Monticielo Odirlei A OA Seguro Luciana Parente Costa LPC Xavier Ricardo M RM Llanos Carolina C Montúfar Guardado Rubén A RA Garcia de la Torre Ignacio I Pineda Carlos C Portela Hernández Margarita M Danza Alvaro A Guibert-Toledano Marlene M Reyes Gil Llerena GL Acosta Colman Maria Isabel MI Aquino Alicia M AM Mora-Trujillo Claudia S CS Muñoz-Louis Roberto R García Valladares Ignacio I Orozco María Celeste MC Burgos Paula I PI Betancur Graciela V GV Alarcón Graciela S GS

Annals of the rheumatic diseases 20180725 11

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 m ...[more]

PMID: 30045853

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Project description:AimTo evaluate the diagnostic performance of the American College of Rheumatology (ACR)-1997, the Systemic Lupus International Collaborating Clinics (SLICC)-2012, and the European League against Rheumatism (EULAR)/ACR-2019 classification criteria in adult patients with systemic lupus erythematosus (SLE).MethodsPubMed, Embase, Web of Science and Cochrane Library databases were searched for literature comparing the three classification criteria of ACR-1997, SLICC-2012 and EULAR/ACR-2019, which took clinical diagnosis as reference. Meta-analysis was used to evaluate and compare the sensitivity, specificity and diagnostic odds ratio of ACR-1997, SLICC-2012 and EULAR/ACR-2019. To assess the early diagnosis capability of the classification criteria, subgroups of patients with disease duration < 3 years and < 1 year were selected for comparison of sensitivity and specificity based on the inclusion of the original study. The sensitivity and specificity of each item in three sets of classification criteria were evaluated. In addition, the clinical and immunological characteristics of patients who did not meet the three classification criteria were compared.ResultsNine original studies were included in the analysis, including 6404 SLE patients and 3996 controls. Results showed that the diagnostic odds ratios (95% confidence interval) of the SLICC-2012 [136.35 (114.94, 161.75)] and EULAR/ACR-2019 [187.47 (158.00, 222.42)] were higher than those of the ACR-1997 [67.53 (58.75, 77.63)]. Compared with ACR-1997[(0.86 (0.82, 0.89)], SLICC-2012[(0.96 (0.93, 0.97)] and EULAR/ACR-2019[(0.95 (0.92, 0.97)] had higher sensitivity. The specificity of the three classification criteria was similar: ACR-1997, SLICC-2012, and EULAR/ACR-2019 were 0.93 (0.89, 0.95), 0.86 (0.79, 0.91), and 0.91 (0.85, 0.95), respectively. The sensitivity of SLICC-2012 and EULAR/ACR-2019 were higher than that of ACR-1997 in early-course subgroups. Patients who did not meet ACR-1997 had more hypocomplementemia, patients who did not meet SLICC-2012 had more cutaneous lupus and photosensitivity, and patients who did not meet EULAR/ACR-2019 had more cutaneous lupus and leucopenia.ConclusionsSLICC-2012 and EULAR/ACR-2019 have better diagnostic ability than the ACR-1997, and the sensitivity of the former two criteria is also higher than that of the latter; Moreover, the SLICC-2012 and EULAR/ACR-2019 for patients in the early stages of disease performed equally excellent.

Dataset Information

First Latin American clinical practice guidelines for the treatment of systemic lupus erythematosus: Latin American Group for the Study of Lupus (GLADEL, Grupo Latino Americano de Estudio del Lupus)-Pan-American League of Associations of Rheumatology (PANLAR).

Publications

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).

Similar Datasets

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