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30-09-2016 | Systemic lupus erythematosus | Review | Article

An Update on Treatment and Management of Pediatric Systemic Lupus Erythematosus

Journal: Rheumatology and Therapy

Authors: Amit Thakral, Marisa S. Klein-Gitelman

Publisher: Springer Healthcare

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Abstract

Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disorder in which 20 % of patients are diagnosed in childhood. Childhood-onset SLE is associated with higher morbidity and mortality than adult-onset SLE. The aims of disease management with early immunosuppression are to decrease disease activity and improve quality of life. A multidisciplinary approach is necessary due to the complexity of lupus in pediatric patients. It is important to provide patients with high quality of care and to instill ownership of their disease process from a young age to prepare them to manage this life-long illness. This article reviews current management of SLE in children.
Literature
1.
Barsalou J, Levy DM, Silverman ED. An update on childhood-onset systemic lupus erythematosus. Curr Opin Rheumatol. 2013;25(5):616–22.CrossRefPubMed
2.
Brunner HI, Huggins J, Klein-Gitelman MS. Pediatric SLE—towards a comprehensive management plan. Nat Rev Rheumatol. 2011;7(4):225–33.CrossRefPubMed
3.
Hollander MC, Sage JM, Greenler AJ, Pendl J, Avcin T, Espada G, et al. International consensus for provisions of quality-driven care in childhood-onset systemic lupus erythematosus. Arthritis Care Res. 2013;65(9):1416–23.CrossRef
4.
Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1997;40(9):1725.CrossRefPubMed
5.
Petri M, Orbai AM, Alarcon GS, Gordon C, Merrill JT, Fortin PR, et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum. 2012;64(8):2677–86.CrossRefPubMedPubMedCentral
6.
Sag E, Tartaglione A, Batu ED, Ravelli A, Khalil SM, Marks SD, et al. Performance of the new SLICC classification criteria in childhood systemic lupus erythematosus: a multicentre study. Clin Exp Rheumatol. 2014;32(3):440–4.PubMed
7.
Hersh AO, Trupin L, Yazdany J, Panopalis P, Julian L, Katz P, et al. Childhood-onset disease as a predictor of mortality in an adult cohort of patients with systemic lupus erythematosus. Arthritis Care Res. 2010;62(8):1152–9.CrossRef
8.
Guiducci C, Gong M, Xu Z, Gill M, Chaussabel D, Meeker T, et al. TLR recognition of self nucleic acids hampers glucocorticoid activity in lupus. Nature. 2010;465(7300):937–41.CrossRefPubMedPubMedCentral
9.
Mina R, von Scheven E, Ardoin SP, Eberhard BA, Punaro M, Ilowite N, et al. Consensus treatment plans for induction therapy of newly diagnosed proliferative lupus nephritis in juvenile systemic lupus erythematosus. Arthritis Care Res. 2012;64(3):375–83.CrossRef
10.
Kasturi S, Sammaritano LR. Corticosteroids in lupus. Rheum Dis Clin N Am. 2016;42(1):47–62.CrossRef
11.
Lam NC, Ghetu MV, Bieniek ML. Systemic lupus erythematosus: primary care approach to diagnosis and management. Am Fam Physician. 2016;94(4):284–94.PubMed
12.
Ruiz-Irastorza G, Danza A, Khamashta M. Glucocorticoid use and abuse in SLE. Rheumatology. 2012;51(7):1145–53.CrossRefPubMed
13.
Costedoat-Chalumeau N, Amoura Z, Hulot JS, Hammoud HA, Aymard G, Cacoub P, et al. Low blood concentration of hydroxychloroquine is a marker for and predictor of disease exacerbations in patients with systemic lupus erythematosus. Arthritis Rheum. 2006;54(10):3284–90.CrossRefPubMed
14.
Bertsias GK, Tektonidou M, Amoura Z, Aringer M, Bajema I, Berden JH, et al. Joint European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of adult and paediatric lupus nephritis. Ann Rheum Dis. 2012;71(11):1771–82.CrossRefPubMedPubMedCentral
15.
Sun L, Liu M, Li R, Zhao Q, Liu J, Yang Y, et al. Hydroxychloroquine, a promising choice for coronary artery disease? Med Hypotheses. 2016;93:5–7.CrossRefPubMed
16.
Shulman S, Wollman J, Brikman S, Padova H, Elkayam O, Paran D. Implementation of recommendations for the screening of hydroxychloroquine retinopathy: poor adherence of rheumatologists and ophthalmologists. Lupus. 2016. doi:10.​1177/​0961203316660204​.
17.
Marmor MF, Hu J. Effect of disease stage on progression of hydroxychloroquine retinopathy. JAMA ophthalmology. 2014;132(9):1105–12.CrossRefPubMed
18.
Ginzler EM, Dooley MA, Aranow C, Kim MY, Buyon J, Merrill JT, et al. Mycophenolate mofetil or intravenous cyclophosphamide for lupus nephritis. N Engl J Med. 2005;353(21):2219–28.CrossRefPubMed
19.
Contreras G, Pardo V, Leclercq B, Lenz O, Tozman E, O’Nan P, et al. Sequential therapies for proliferative lupus nephritis. N Engl J Med. 2004;350(10):971–80.CrossRefPubMed
20.
Tornatore KM, Meaney CJ, Wilding GE, Chang SS, Gundroo A, Cooper LM, et al. Influence of sex and race on mycophenolic acid pharmacokinetics in stable African American and Caucasian renal transplant recipients. Clin Pharmacokinet. 2015;54(4):423–34.CrossRefPubMedPubMedCentral
21.
Rostas S, Kim M, Gabardi S. Risk evaluation and mitigation strategies: a focus on the mycophenolic acid preparations. Prog Transpl. 2014;24(1):33–6.CrossRef
22.
Sinha R, Raut S. Pediatric lupus nephritis: management update. World J Nephrol. 2014;3(2):16–23.PubMedPubMedCentral
23.
Houssiau FA, Vasconcelos C, D’Cruz D, Sebastiani GD, de Ramon Garrido E, Danieli MG, et al. The 10-year follow-up data of the euro-lupus nephritis trial comparing low-dose and high-dose intravenous cyclophosphamide. Ann Rheum Dis. 2010;69(1):61–4.CrossRefPubMed
24.
Oktem O, Guzel Y, Aksoy S, Aydin E, Urman B. Ovarian function and reproductive outcomes of female patients with systemic lupus erythematosus and the strategies to preserve their fertility. Obstet Gynecol Surv. 2015;70(3):196–210.CrossRefPubMed
25.
Leroy C, Rigot JM, Leroy M, Decanter C, Le Mapihan K, Parent AS, et al. Immunosuppressive drugs and fertility. Orphanet J Rare Dis. 2015;10:136.CrossRefPubMedPubMedCentral
26.
Pryor BD, Bologna SG, Kahl LE. Risk factors for serious infection during treatment with cyclophosphamide and high-dose corticosteroids for systemic lupus erythematosus. Arthritis Rheum. 1996;39(9):1475–82.CrossRefPubMed
27.
Haga HJ, D’Cruz D, Asherson R, Hughes GR. Short term effects of intravenous pulses of cyclophosphamide in the treatment of connective tissue disease crisis. Ann Rheum Dis. 1992;51(7):885–8.CrossRefPubMedPubMedCentral
28.
Thompson AJ, Newman WG, Elliott RA, Roberts SA, Tricker K, Payne K. The cost-effectiveness of a pharmacogenetic test: a trial-based evaluation of TPMT genotyping for azathioprine. Value Health J Int Soc Pharmacoecon Outcomes Res. 2014;17(1):22–33.CrossRef
29.
Meggitt SJ, Anstey AV, Mohd Mustapa MF, Reynolds NJ, Wakelin S. British Association of Dermatologists’ guidelines for the safe and effective prescribing of azathioprine 2011. Br J Dermatol. 2011;165(4):711–34.CrossRefPubMed
30.
Abdwani R, Mani R. Anti-CD20 monoclonal antibody in acute life threatening haemolytic anaemia complicating childhood-onset SLE. Lupus. 2009;18(5):460–4.CrossRefPubMed
31.
Illei GG, Cervera R, Burt RK, Doria A, Hiepe F, Jayne D, et al. Current state and future directions of autologous hematopoietic stem cell transplantation in systemic lupus erythematosus. Ann Rheum Dis. 2011;70(12):2071–4.CrossRefPubMedPubMedCentral
32.
Reddy V, Martinez L, Isenberg DA, Leandro MJ, Cambridge G. Pragmatic treatment of patients with Systemic Lupus Erythematosus with rituximab: Long-term effects on serum immunoglobulins. Arthritis Care Res. 2016. doi:10.​1002/​acr.​22993.
33.
Weintraub B. Belimumab efficacy is ‘mild’ but market potential still greatdagger: anticipating us approval of the first lupus drug since 1957. BioDrugs Clin Immunother Biopharm Gene Ther. 2011;25(3):203–5.
34.
Do RK, Hatada E, Lee H, Tourigny MR, Hilbert D, Chen-Kiang S. Attenuation of apoptosis underlies B lymphocyte stimulator enhancement of humoral immune response. J Exp Med. 2000;192(7):953–64.CrossRefPubMedPubMedCentral
35.
Hui-Yuen JS, Nguyen SC, Askanase AD. Targeted B cell therapies in the treatment of adult and pediatric systemic lupus erythematosus. Lupus. 2016;25(10):1086–96.CrossRefPubMed
36.
Fernandez D, Bonilla E, Mirza N, Niland B, Perl A. Rapamycin reduces disease activity and normalizes T cell activation-induced calcium fluxing in patients with systemic lupus erythematosus. Arthritis Rheum. 2006;54(9):2983–8.CrossRefPubMedPubMedCentral
37.
Postal M, Costallat LT, Appenzeller S. Biological therapy in systemic lupus erythematosus. Int J Rheumatol. 2012;2012:578641.CrossRefPubMedPubMedCentral
38.
Falcini F, Nacci F. Systemic lupus erythematosus in the young: the importance of a transition clinic. Lupus. 2007;16(8):613–7.CrossRefPubMed
39.
Lawson EF, Hersh AO, Applebaum MA, Yelin EH, Okumura MJ, von Scheven E. Self-management skills in adolescents with chronic rheumatic disease: a cross-sectional survey. Pediatr Rheumatol Online J. 2011;9(1):35.CrossRefPubMedPubMedCentral
40.
Fredericks EM, Magee JC, Opipari-Arrigan L, Shieck V, Well A, Lopez MJ. Adherence and health-related quality of life in adolescent liver transplant recipients. Pediatr Transplant. 2008;12(3):289–99.CrossRefPubMed
41.
Tunnicliffe DJ, Singh-Grewal D, Chaitow J, Mackie F, Manolios N, Lin MW, et al. Lupus means sacrifices: perspectives of adolescents and young adults with systemic lupus erythematosus. Arthritis Care Res. 2016;68(6):828–37.CrossRef
42.
Son MB, Sergeyenko Y, Guan H, Costenbader KH. Disease activity and transition outcomes in a childhood-onset systemic lupus erythematosus cohort. Lupus. 2016. doi:10.​1177/​0961203316640913​.
43.
Felsenstein S, Reiff AO, Ramanathan A. Transition of care and health-related outcomes in pediatric-onset systemic lupus erythematosus. Arthritis Care Res. 2015;67(11):1521–8.CrossRef
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