TY - JOUR
T1 - First Latin American clinical practice guidelines for the treatment of systemic lupus erythematosus
T2 - Latin American Group for the Study of Lupus (GLADEL, Grupo Latino Americano de Estudio del Lupus)-Pan-American League of Associations of Rheumatology (PANLAR)
AU - Pons-Estel, Bernardo A.
AU - Bonfa, Eloisa
AU - Soriano, Enrique R.
AU - Cardiel, Mario H.
AU - Izcovich, Ariel
AU - Popoff, Federico
AU - Criniti, Juan M.
AU - Vásquez, Gloria
AU - Massardo, Loreto
AU - Duarte, Margarita
AU - Barile-Fabris, Leonor A.
AU - García, Mercedes A.
AU - Amigo, Mary Carmen
AU - Espada, Graciela
AU - Catoggio, Luis J.
AU - Sato, Emilia Inoue
AU - Levy, Roger A.
AU - Acevedo Vásquez, Eduardo M.
AU - Chacón-DÍaz, Rosa
AU - Galarza-Maldonado, Claudio M.
AU - Iglesias Gamarra, Antonio J.
AU - Molina, José Fernando
AU - Neira, Oscar
AU - Silva, Clóvis A.
AU - Vargas Peña, Andrea
AU - Gómez-Puerta, José A.
AU - Scolnik, Marina
AU - Pons-Estel, Guillermo J.
AU - Ugolini-Lopes, Michelle R.
AU - Savio, Verónica
AU - Drenkard, Cristina
AU - Alvarellos, Alejandro J.
AU - Ugarte-Gil, Manuel F.
AU - Babini, Alejandra
AU - Cavalcanti, André
AU - Cardoso Linhares, Fernanda Athayde
AU - Haye Salinas, Maria Jezabel
AU - Fuentes-Silva, Yurilis J.
AU - Montandon De Oliveira E Silva, Ana Carolina
AU - Eraso Garnica, Ruth M.
AU - Herrera Uribe, Sebastián
AU - Gómez-Martín, DIana
AU - Robaina Sevrini, Ricardo
AU - Quintana, Rosana M.
AU - Gordon, Sergio
AU - Fragoso-Loyo, Hilda
AU - Rosario, Violeta
AU - Saurit, Verónica
AU - Appenzeller, Simone
AU - Dos Reis Neto, Edgard Torres
AU - Cieza, Jorge
AU - González Naranjo, Luis A.
AU - González Bello, Yelitza C.
AU - Collado, María Victoria
AU - Sarano, Judith
AU - Retamozo, Soledad
AU - Sattler, María E.
AU - Gamboa-Cárdenas, Rocio V.
AU - Cairoli, Ernesto
AU - Conti, Silvana M.
AU - Amezcua-Guerra, Luis M.
AU - Silveira, Luis H.
AU - Borba, Eduardo F.
AU - Pera, Mariana A.
AU - Alba Moreyra, Paula B.
AU - Arturi, Valeria
AU - Berbotto, Guillermo A.
AU - Gerling, Cristian
AU - Gobbi, Carla A.
AU - Gervasoni, Viviana L.
AU - Scherbarth, Hugo R.
AU - Brenol, João C.Tavares
AU - Cavalcanti, Fernando
AU - Costallat, Lilian T.Lavras
AU - Da Silva, Nilzio A.
AU - Monticielo, Odirlei A.
AU - Seguro, Luciana Parente Costa
AU - Xavier, Ricardo M.
AU - Llanos, Carolina
AU - Montúfar Guardado, Rubén A.
AU - Garcia De La Torre, Ignacio
AU - Pineda, Carlos
AU - Portela Hernández, Margarita
AU - Danza, Alvaro
AU - Guibert-Toledano, Marlene
AU - Reyes, Gil Llerena
AU - Acosta Colman, Maria Isabel
AU - Aquino, Alicia M.
AU - Mora-Trujillo, Claudia S.
AU - Muñoz-Louis, Roberto
AU - García Valladares, Ignacio
AU - Orozco, María Celeste
AU - Burgos, Paula I.
AU - Betancur, Graciela V.
AU - Alarcón, Graciela S.
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2018/11/1
Y1 - 2018/11/1
N2 - 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.
AB - 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.
KW - lupus nephritis
KW - systemic lupus erythematosus
KW - treatment
UR - http://www.scopus.com/inward/record.url?scp=85050598145&partnerID=8YFLogxK
U2 - 10.1136/annrheumdis-2018-213512
DO - 10.1136/annrheumdis-2018-213512
M3 - Article
C2 - 30045853
AN - SCOPUS:85050598145
SN - 0003-4967
VL - 77
SP - 1549
EP - 1557
JO - Annals of the rheumatic diseases
JF - Annals of the rheumatic diseases
IS - 11
ER -