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)

被引：122

作者：

Pons-Estel, Bernardo A. ^{[1
]}

Bonfa, Eloisa ^{[2
]}

Soriano, Enrique R. ^{[3
,4
]}

Cardiel, Mario H. ^{[5
]}

Izcovich, Ariel ^{[6
]}

Popoff, Federico ^{[6
]}

Criniti, Juan M. ^{[6
]}

Vasquez, Gloria ^{[7
]}

Massardo, Loreto ^{[8
]}

Duarte, Margarita ^{[9
]}

Barile-Fabris, Leonor A. ^{[10
]}

Garcia, Mercedes A. ^{[11
]}

Amigo, Mary-Carmen ^{[12
]}

Espada, Graciela ^{[13
]}

Catoggio, Luis J. ^{[3
,4
]}

Sato, Emilia Inoue ^{[14
]}

Levy, Roger A. ^{[15
]}

Acevedo Vasquez, Eduardo M. ^{[16
]}

Chacon-Diaz, Rosa ^{[17
]}

Galarza-Maldonado, Claudio M. ^{[18
]}

Iglesias Gamarra, Antonio J. ^{[19
]}

Fernando Molina, Jose ^{[20
]}

Neira, Oscar ^{[21
,22
]}

Silva, Clovis A. ^{[23
]}

Vargas Pena, Andrea ^{[24
,25
]}

Gomez-Puerta, Jose A. ^{[26
]}

Scolnik, Marina ^{[3
,4
]}

Pons-Estel, Guillermo J. ^{[1
,27
]}

Ugolini-Lopes, Michelle R. ^{[2
]}

Savio, Veronica ^{[28
]}

Drenkard, Cristina ^{[29
]}

Alvarellos, Alejandro J. ^{[30
]}

Ugarte-Gil, Manuel F. ^{[31
,32
]}

Babini, Alejandra ^{[28
]}

Cavalcanti, Andre ^{[33
]}

Cardoso Linhares, Fernanda Athayde ^{[24
,25
]}

Haye Salinas, Maria Jezabel ^{[30
]}

Fuentes-Silva, Yurilis J. ^{[34
]}

Montandon de Oliveira e Silva, Ana Carolina ^{[35
]}

Eraso Garnica, Ruth M. ^{[36
]}

Herrera Uribe, Sebastian ^{[37
]}

Gomez-Martin, Diana ^{[38
]}

Robaina Sevrini, Ricardo ^{[39
]}

Quintana, Rosana M. ^{[1
,27
]}

Gordon, Sergio ^{[40
]}

Fragoso-Loyo, Hilda ^{[38
]}

Rosario, Violeta ^{[41
]}

Saurit, Veronica ^{[30
]}

Appenzeller, Simone ^{[42
]}

dos Reis Neto, Edgard Torres ^{[14
]}

机构：

[1] GO CREAR, Dept Med Interna, Rosario, Santa Fe, Argentina

[2] Univ Sao Paulo, Hosp Clin, Div Rheumatol, Fac Med, Sao Paulo, Brazil

[3] Hosp Italiano Buenos Aires, Escuela Med, Inst Univ, Secc Reumatol,Serv Clin Med, Buenos Aires, DF, Argentina

[4] Hosp Italiano Buenos Aires, Fdn Dr Pedro M Catoggio Progreso Reumatol, Buenos Aires, DF, Argentina

[5] Ctr Invest Clin Morelia SC, Morelia, Michoacan, Mexico

[6] Hosp Aleman Buenos Aires, Serv Clin Med, Buenos Aires, DF, Argentina

[7] Univ Antioquia, Hosp Univ Fdn, Grp Inmunol Celular & Inmunogenet, Medellin, Colombia

[8] Univ San Sebastian, Fac Med & Ciencia, Ctr Biol Celular & Biomed, Santiago, Chile

[9] Univ Nacl Asuncion, Fac Ciencias Med, Hosp Clin, Dept Reumatol, Asuncion, Paraguay

[10] Hosp Angeles Pedregal, Mexico City, DF, Mexico

[11] HIGA Gen San Martin, Serv Reumatol, La Plata, Buenos Aires, Argentina

[12] Ctr Med ABC, Serv Reumatol, Mexico City, DF, Mexico

[13] Hosp Ninos Dr Ricardo Gutierrez, Serv Reumatol, Buenos Aires, DF, Argentina

[14] Univ Fed Sao Paulo, Escola Paulista Med, Sao Paulo, Brazil

[15] Univ State Rio Janeiro, Discipline Rheumatol, Rio De Janeiro, Brazil

[16] Univ Nacl Mayor San Marcos, Serv Reumatol, Fac Med, Clin San Felipe, Lima, Peru

[17] Policlin Mendez Gimon, Serv Reumatol, Caracas, Venezuela

[18] Corp Med Monte Sinai, Unidad Enfermedades Reumat & Autoinmunes UNERA, Cuenca, Ecuador

[19] Univ Nacl Colombia, Bogota, Colombia

[20] Ctr Integral Reumatol, Reumalab, Medellin, Colombia

[21] Univ Chile, Hosp Salvador, Secc Reumatol, Santiago, Chile

[22] Univ Desarrollo, Fac Med Clin Alemana, Clin Alemana Santiago, Unidad Reumatol, Santiago, Chile

[23] Univ Sao Paulo, Hosp Clin, Fac Med, Pediat Dept,Childrens Inst, Sao Paulo, Brazil

[24] Univ Republica, Clin Reumatol, Montevideo, Uruguay

[25] Hosp Pasteur, Inst Nacl Reumatol, Unidad Docente Asistencial, Montevideo, Uruguay

[26] Hosp Clin Barcelona, Serv Reumatol, Barcelona, Spain

[27] Hosp Prov Rosario, Serv Reumatol, Rosario, Argentina

[28] Hosp Italiano Cordoba, Serv Reumatol, Cordoba, Argentina

[29] Emory Sch Med, Dept Med, Div Rheumatol, Atlanta, GA USA

[30] Hosp Privado Univ Cordoba, Serv Reumatol, Cordoba, Argentina

[31] Hosp Gen Guillermo Almenara Irigoyen, EsSalud, Serv Reumatol, Lima, Peru

[32] Univ Cient Sur, Lima, Peru

[33] Univ Fed Pernambuco, Hosp Clin, Serv Reumatol, Recife, PE, Brazil

[34] Univ Oriente, Complejo Hosp Univ Ruiz & Paez, Dept Med, Unidad Reumatol, Ciudad Bolivar, Venezuela

[35] Univ Fed Goias, Hosp Clin, Fac Med, Serv Reumatol,Dept Clin Med, Goiania, Go, Brazil

[36] Univ Antioquia, Hosp Pablo Tobon Uribe, Fac Med, Dept Pediat, Medellin, Colombia

[37] Hosp Gen Medellin Luz Castro de Gutierrez, ESE, ARTMEDICA, Serv Reumatol, Medellin, Colombia

[38] Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Dept Inmunol & Reumatol, Mexico City, DF, Mexico

[39] Univ Republica, Hosp Clin, Unidad Enfermedades Autoinmunes Sistem, Fac Med,Clin Med C, Montevideo, Uruguay

[40] HIGA Dr Oscar Alende, Unidad Reumatol & Enfermedades Autoinmunes Sistem, Mar Del Plata, Buenos Aires, Argentina

[41] Hosp Docente Padre Billini, Serv Reumatol Enfermedades Reumatol & Invest Clin, Santo Domingo, Dominican Rep

[42] Univ Estadual Campinas, UNICAMP, Fac Med, Dept Clin Med,Disciplina Reumatol, Campinas, SP, Brazil

[43] Hosp Nacl Edgardo Rebagliati Martins, EsSalud, Dept Especialidades Med, Serv Reumatol, Lima, Peru

[44] CEIBAC SC, Serv Reumatol, Guadalajara, Jalisco, Mexico

[45] Inst Invest Med Alfredo Lanari, Serv Inmunol, Buenos Aires, DF, Argentina

[46] Hosp Escuela Eva Peron, Serv Reumatol, Granadero Baigorria, Argentina

[47] Inst Nacl Cardiol Ignacio Chavez, Dept Inmunol, Mexico City, DF, Mexico

[48] Inst Nacl Cardiol Ignacio Chavez, Dept Reumatol, Mexico City, DF, Mexico

[49] Univ Nacl Cordoba, Fac Ciencias Med, Catedra Semiol, Unidad Reumatol,Catedra Clin Med 1,Hosp Cordoba, Cordoba, Argentina

[50] Univ Fed Rio Grande do Sul, Hosp Clin Porto Alegre, Dept Internal Med, Div Rheumatol, Porto Alegre, RS, Brazil

来源：

ANNALS OF THE RHEUMATIC DISEASES | 2018年 / 77卷 / 11期

关键词：

3; ETHNIC-GROUPS; COLLEGE-OF-RHEUMATOLOGY; INCEPTION COHORT; DISEASE; DAMAGE; HYDROXYCHLOROQUINE; MORTALITY; RISK; MANAGEMENT; ANCESTRY;

D O I：

10.1136/annrheumdis-2018-213512

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

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.

引用

页码：1549 / 1557

页数：9

共 51 条

[1]

A consensus of the Chilean Nephrology and Rheumatology Societies on renal involvement in systemic lupus erythematosus [J].

Aguirre, Veronica ;

Alvo, Miriam ;

Ardiles, Leopoldo ;

Daniel Carpio, J. ;

Foster, Carolina ;

Goecke, Annelise ;

Jalil, Roberto ;

Massardo, Loreto ;

Palma, Sergio ;

Roessler, Emilio ;

Wurgaft, Andres .

REVISTA MEDICA DE CHILE, 2015, 143 (12) :1569-1578

[2]

Effect of hydroxychloroquine on the survival of patients with systemic lupus erythematosus:: Data from LUMINA, a multiethnic US cohort (LUMINA L) [J].

Alarcon, Graciela S. ;

McGwin, Gerald ;

Bertoli, Ana M. ;

Fessler, Barri J. ;

Calvo-Alen, Jaime ;

Bastian, Holly M. ;

Vila, Luis M. ;

Reveille, John D. .

ANNALS OF THE RHEUMATIC DISEASES, 2007, 66 (09) :1168-1172

[3]

Alarcón GS, 2001, ARTHRIT RHEUM-ARTHR, V45, P191, DOI 10.1002/1529-0131(200104)45:2<191::AID-ANR173>3.0.CO

[4]

2-2

[5]

Alarcón GS, 2001, ARTHRITIS RHEUM, V44, P2797, DOI 10.1002/1529-0131(200112)44:12<2797::AID-ART467>3.0.CO

[6]

2-9

[7]

Genome-Wide Association Study in an Amerindian Ancestry Population Reveals Novel Systemic Lupus Erythematosus Risk Loci and the Role of European Admixture [J].

Alarcon-Riquelme, Marta E. ;

Ziegler, Julie T. ;

Molineros, Julio ;

Howard, Timothy D. ;

Moreno-Estrada, Andres ;

Sanchez-Rodriguez, Elena ;

Ainsworth, Hannah C. ;

Ortiz-Tello, Patricia ;

Comeau, Mary E. ;

Rasmussen, Astrid ;

Kelly, Jennifer A. ;

Adler, Adam ;

Acevedo-Vazquez, Eduardo M. ;

Cucho-Venegas, Jorge Mariano ;

Garcia-De la Torre, Ignacio ;

Cardiel, Mario H. ;

Miranda, Pedro ;

Catoggio, Luis J. ;

Maradiaga-Cecena, Marco ;

Gaffney, Patrick M. ;

Vyse, Timothy J. ;

Criswell, Lindsey A. ;

Tsao, Betty P. ;

Sivils, Kathy L. ;

Bae, Sang-Cheol ;

James, Judith A. ;

Kimberly, Robert P. ;

Kaufman, Kenneth M. ;

Harley, John B. ;

Esquivel-Valerio, Jorge A. ;

Moctezuma, Jose F. ;

Garcia, Mercedes A. ;

Berbotto, Guillermo A. ;

Babini, Alejandra M. ;

Scherbarth, Hugo ;

Toloza, Sergio ;

Baca, Vicente ;

Nath, Swapan K. ;

Salinas, Carlos Aguilar ;

Orozco, Lorena ;

Tusie-Luna, Teresa ;

Zidovetzki, Raphael ;

Pons-Estel, Bernardo A. ;

Langefeld, Carl D. ;

Jacob, Chaim O. .

ARTHRITIS & RHEUMATOLOGY, 2016, 68 (04) :932-943

[8]

Familial aggregation of systemic lupus erythematosus, rheumatoid arthritis, and other autoimmune diseases in 1,177 lupus patients from the GLADEL cohort [J].

Alarcon-Segovia, D ;

Alarcón-Riquelme, ME ;

Cardiel, MH ;

Caeiro, F ;

Massardo, L ;

Villa, AR ;

Pons-Estel, BA .

ARTHRITIS AND RHEUMATISM, 2005, 52 (04) :1138-1147

[9]

Controlled clinical trial of IV cyclophosphamide versus IV methylprednisolone in severe neurological manifestations in systemic lupus erythematosus [J].

Barile-Fabris, L ;

Ariza-Andraca, R ;

Olguín-Ortega, L ;

Jara, LJ ;

Fraga-Mouret, A ;

Miranda-Limón, JM ;

de la Mata, JF ;

Clark, P ;

Vargas, F ;

Alcocer-Varela, J .

ANNALS OF THE RHEUMATIC DISEASES, 2005, 64 (04) :620-625

[10]

Mortality in systemic lupus erythematosus [J].

Bernatsky, S. ;

Boivin, J. -F. ;

Joseph, L. ;

Manzi, S. ;

Ginzler, E. ;

Gladman, D. D. ;

Urowitz, M. ;

Fortin, P. R. ;

Petri, M. ;

Barr, S. ;

Gordon, C. ;

Bae, S. -C. ;

Isenberg, D. ;

Zoma, A. ;

Aranow, C. ;

Dooley, M. -A. ;

Nived, O. ;

Sturfelt, G. ;

Steinsson, K. ;

Alarcon, G. ;

Senecal, J. -L. ;

Zummer, M. ;

Hanly, J. ;

Ensworth, S. ;

Pope, J. ;

Edworthy, S. ;

Rahman, A. ;

Sibley, J. ;

El-Gabalawy, H. ;

McCarthy, T. ;

Pierre, Y. St. ;

Clarke, A. ;

Ramsey-Goldman, R. .

ARTHRITIS AND RHEUMATISM, 2006, 54 (08) :2550-2557

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