Publications by authors named "Pego-Reigosa J"
Introduction: Belimumab (BEL), an anti B-lymphocyte stimulator monoclonal antibody, is the only approved biological therapy for systemic lupus erythematosus (SLE) and lupus nephritis (LN).
Areas Covered: This review discusses BEL's real-world use and its positioning in clinical practice guidelines, focusing on the evolution of its application and patient profile over the last decade in Spain.
Expert Opinion: Initially used for refractory, non-major SLE manifestations, BEL's application has expanded.
Objective: We aimed to quantify the mortality risk in a large, well-characterized cohort of patients with Sjögren disease (SjD) and to identify independent predictors of mortality in this population.
Methods: We included 314 patients diagnosed with SjD according to the 2002 American-European Consensus Group criteria from a prospective, multicenter SjögrenSER Prospective cohort. Detailed data on systemic manifestations, serological markers, disease activity, and mortality were collected after a median of 9.
Objective: To evaluate the main outcomes of disease activity and their association with other measures of activity, damage, and quality of life in patients with idiopathic inflammatory myopathy (IIM) according to time since diagnosis and positivity to antisynthetase autoantibodies (ASAs).
Methods: Cross-sectional multicenter study within the Spanish Myo-Spain registry. Cases were classified as incident (≤ 12 months since diagnosis) and prevalent.
Introduction: Endothelial progenitor cells (EPCs) are essential for maintenance of vascular homeostasis and stability, key processes in the pathogenesis of systemic lupus erythematosus (SLE). However, the role and phenotypic characterization of EPCs populations in SLE have not been completely elucidated.
Objective: To identify EPCs specific subpopulations in patients with SLE using a novel flow cytometry tool.
Article Synopsis
- Diffuse alveolar hemorrhage (DAH) is a severe and uncommon complication in systemic lupus erythematosus (SLE) patients, with early diagnosis and treatment critical for improving survival rates.
- In a study from the RELESSER register, 37 out of 4024 SLE patients experienced DAH, with notable characteristics including a high prevalence of women and links to renal issues and thrombocytopenia.
- Factors associated with higher mortality in DAH patients included smoking, prior lupus nephritis, infections, and the use of cyclophosphamide, with a mortality rate of 35.7% observed in the cohort.
Objective: To assess organ damage, with emphasis on the cardiovascular system, over the different stages of the disease in a large SLE cohort.
Methods: Multicentre, longitudinal study of a cohort of 4219 patients with SLE enrolled in the Spanish Society of Rheumatology Lupus Registry. Organ damage was ascertained using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI).
Article Synopsis
- Hydroxychloroquine (HCQ) is the main treatment for systemic lupus erythematosus (SLE), but its use varies widely among clinicians. A consensus was created to standardize recommendations for healthcare providers.
- A systematic literature review led to the identification of relevant studies, resulting in a total of 11 recommendations for the appropriate use of HCQ, covering initiation, maintenance, and monitoring. All committee members unanimously agreed on these guidelines.
- The evidence supports HCQ's safety and effectiveness, emphasizing the importance of tailored dosing and careful monitoring to balance treatment benefits against risks, particularly concerning retinal toxicity and SLE flare-ups.
Objectives: The aims of this study were to investigate the prevalence of dose reduction in patients with SLE treated with belimumab (BEL) in Spain, analyse treatment modalities, and determine impact on control of disease activity.
Methods: Retrospective longitudinal and multicentre study of SLE patients treated with BEL. Data on disease activity, treatments and outcomes were recorded before and after reduction (6-12 months), and they were compared.
Objective: To develop an improved score for prediction of severe infection in patients with systemic lupus erythematosus (SLE), namely, the SLE Severe Infection Score-Revised (SLESIS-R) and to validate it in a large multicentre lupus cohort.
Methods: We used data from the prospective phase of RELESSER (RELESSER-PROS), the SLE register of the Spanish Society of Rheumatology. A multivariable logistic model was constructed taking into account the variables already forming the SLESIS score, plus all other potential predictors identified in a literature review.
Objectives: To provide an overview on the current use of belimumab (BLM) in SLE patients in clinical practice and to examine its efficacy in terms of standardized outcomes, drug survival, as well as patient and safety profiles.
Methods: A longitudinal retrospective multicenter cohort including SLE patients treated with BLM at 18 Spanish centers. Data was collected upon initiation of BLM, at 6 and 12 months after initiation, and at the last recorded visit.
Previous works from our group show that Semaphorin3B (Sema3B) is reduced in RA and plays a protective role in a mouse arthritis model. In turn, MerTK plays a protective function in murine arthritis models, is expressed by synovial tissue macrophages and is linked to remission in patients with RA. In this study, we examined the role of Sema3B in the phenotypic characteristics of RA macrophages and the implication of MerTK.
View Article and Find Full Text PDFObjectives: To update the EULAR recommendations for the management of systemic lupus erythematosus (SLE) based on emerging new evidence.
Methods: An international Task Force formed the questions for the systematic literature reviews (January 2018-December 2022), followed by formulation and finalisation of the statements after a series of meetings. A predefined voting process was applied to each overarching principle and recommendation.
Objective: To analyze the effectiveness and safety of intravenous immunoglobulin (IVIG) given in routine care to patients with systemic sclerosis (SSc).
Methods: A retrospective multicenter observational study was conducted in SSc patients treated with IVIG. We collected data on epidemiological parameters and clinical outcomes.
Introduction: Obstetric complications are more common in women with systemic lupus erythematosus (SLE) than in the general population.
Objective: To assess pregnancy outcomes in women with SLE from the RELESSER cohort after 12 years of follow-up.
Methods: A multicentre retrospective observational study was conducted.
Objectives: To assess agreement between the 2021 Definition Of Remission In SLE (DORIS) and physician-judged lupus activity.
Methods: A cross-sectional analysis was conducted of data from a Spanish prospective multicentre study of SLE patients. We applied the 2021 DORIS criteria and assessed whether remission status based on this definition agreed with remission as per physician clinical judgement and reasons for disagreement between them.
Objective: Class 3 semaphorins are reduced in the synovial tissue of RA patients and these proteins are involved in the pathogenesis of the disease. The aim of this study was to identify the transcription factors involved in the expression of class 3 semaphorins in the synovium of RA patients.
Methods: Protein and mRNA expression in synovial tissue from RA and individuals at risk (IAR) patients, human umbilical vein endothelial cells (HUVEC) and RA fibroblast-like synoviocytes (FLS) was determined by ELISA, immunoblotting and quantitative PCR.
Article Synopsis
- The study analyzed how common major central nervous system issues are in patients with systemic lupus erythematosus (SLE) and their impact on survival and mortality.
- Out of 3,591 SLE patients, 11.5% experienced significant CNS neuropsychiatric problems, leading to higher annual mortality rates, particularly from cerebrovascular disease and organic brain syndrome.
- The findings indicate that major CNS complications significantly increase mortality risk, with specific issues like CVD and organic brain syndrome having the worst survival outcomes.
Objectives: To apply the lupus low disease activity state (LLDAS) definition within a large cohort of patients and to assess the agreement between the LLDAS and the physician's subjective evaluation of lupus activity.
Methods: We conducted a cross-sectional analysis of a prospective multicentre study of SLE patients. We applied the LLDAS and assessed whether there was agreement with the clinical status according to the physician's opinion.
Article Synopsis
- The study aimed to evaluate the characteristics and lymphoma risk in patients with systemic lupus erythematosus (SLE) using data from a large Spanish registry.
- Researchers found 21 SLE patients with lymphoma compared to 3,965 without, noting that the majority of lymphomas were B cell types, particularly diffuse large B cell lymphoma.
- Key findings indicated that male patients and older individuals had a higher lymphoma risk, and certain SLE-related symptoms were more prevalent in the lymphoma group, while the use of antimalarials was linked to a reduced lymphoma risk; further studies are suggested for confirmation.
Study of Plasma Anti-CD26 Autoantibody Levels in a Cohort of Treatment-Naïve Early Arthritis Patients.
Arch Immunol Ther Exp (Warsz)
March 2022
Article Synopsis
- Identifying effective biomarkers for early-stage rheumatoid arthritis (RA) remains difficult, highlighting the need for novel markers in diagnosis and treatment adjustment.
- This study investigates the diagnostic potential of autoantibodies (Anti-CD26 aAbs) in 106 treatment-naïve early arthritis patients, revealing different isotype patterns linked to RA and undifferentiated arthritis.
- Findings suggest that Anti-CD26 aAbs may serve as important biomarkers and possible contributors to the disease in both seropositive and seronegative patients, even with weak correlations to traditional disease activity indicators.
Spondyloarthritis (SpA) is a family of chronic inflammatory diseases, being the most prevalent ankylosing spondylitis (AS) and psoriatic arthritis (PsA). These diseases share genetic, clinical and immunological features, such as the implication of human leukocyte antigen (HLA) class I molecule 27 (HLA-B27), the inflammation of peripheral, spine and sacroiliac joints and the presence of extra-articular manifestations (psoriasis, anterior uveitis, enthesitis and inflammatory bowel disease). Monocytes and macrophages are essential cells of the innate immune system and are the first line of defence against external agents.
View Article and Find Full Text PDFObjectives: To describe different models of multidisciplinary pregnancy care for patients with inflammatory and autoimmune rheumatic diseases, and the steps to follow concerning their implementation.
Methods: A qualitative study was conducted including: (1) a comprehensive literature search in PUBMED focused on multidisciplinary care models; (2) structured interviews with seven rheumatologists from multidisciplinary pregnancy clinics for patients with inflammatory and autoimmune rheumatic diseases. Data were collected related to the hospitals, medical departments, populations cared for, and multidisciplinary care models (type, material, and human resources, professional requirements, objectives, referral criteria, agendas, protocols, responsibilities, decision-making, research and educational activities, multidisciplinary clinical sessions, initiation/start, planning, advantages/disadvantages, and barriers/facilitators for implementation); (3) a nominal meeting group in which the results of searches and interviews were analyzed and the recommendations for the implementation of the multidisciplinary care models defined.
Background/objectives: Factors associated with chronic heart failure (CHF) in patients with systemic lupus erythematosus (SLE) have received little attention. Recent data on the use of hydroxychloroquine in the treatment of SARS-CoV-2 infection have cast doubt on its cardiac safety. The factors associated with CHF, including therapy with antimalarials, were analyzed in a large multicenter SLE cohort.
View Article and Find Full Text PDFObjective: To describe in detail an innovative program based on telemedicine for semi-automated prioritization of referrals from Primary Care (PC) to Rheumatology, for reproducibility purposes, and to present the results of the implementation study.
Methods: The context and situation were carefully analyzed, paying attention to all processes in place, referral numbers, waiting times, and number of complementary tests prior to discharge from Rheumatology. The composition of the team, aims, users, scope, and implementation phases were defined.