Publications by authors named "Rua-Figueroa I"
Anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis is characterised by small vessel necrotising inflammatory vasculitis. Prior to immunosupressant therapy availability it usually led to a fatal outcome. Current treatment has changed ANCA-associated vasculitis into a condition with a significant response rate, although with a not negligible relapse occurrence and cumulative organ lesions, mostly due to drug-related toxicities.
View Article and Find Full Text PDFObjective: 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.
Ten clinical conundrums in the management of eosinophilic granulomatosis with polyangiitis.
Expert Rev Clin Immunol
November 2024
Introduction: Eosinophilic granulomatosis with polyangiitis (EGPA) is an immune-mediated, inflammatory, multisystemic disease that is considered a form of ANCA-associated vasculitis and whose association with asthma and blood and tissue eosinophilia differentiate it from other types of vasculitis. Nevertheless, diagnosis of EGPA may be difficult or delayed not only because of the rarity of the disease, but also because other diseases can present with similar manifestations.
Areas Covered: We review a series of key areas in EGPA, namely, laboratory and clinical indicators of disease, diagnosis, role of biomarkers, induction and maintenance therapy, and use of traditional and novel drugs.
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.
Background: Eosinophilic granulomatosis with polyangiitis (EGPA), is a rare ANCA-associated systemic vasculitis. Its overlapping features with other vasculitic or eosinophilic diseases, and the wide and heterogeneous range of clinical manifestations, often result in a delay to diagnosis.
Objective: To identify red flags that raise a suspicion of EGPA to prompt diagnostic testing and to present an evidence-based clinical checklist tool for use in routine clinical practice.
Objectives: The aims of this study were to investigate the prevalence of dose reduction in patients with SLE treated with belimumab (BEL) in Spain, analyze 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.
Article Synopsis
- - Eosinophil-related diseases have varying symptoms and can range from mild to severe, typically treated with glucocorticoids.
- - Novel biologic therapies targeting the interleukin-5 pathway are gaining approval, offering an alternative to reduce glucocorticoid use and associated side effects.
- - Experts reviewed evidence on glucocorticoid treatment in systemic eosinophilic diseases (like EGPA and HES) and respiratory eosinophilic diseases (like CRSwNP and SA-EP), reaching a consensus on dosing, tapering strategies, and the timing of biologic therapies to minimize adverse effects.
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.
Article Synopsis
- The study characterizes the complement (C) pathways in patients with systemic lupus erythematosus (SLE), focusing on the functional assays of the Classical, Lectin, and Alternative pathways.
- Functional assays were conducted on 284 SLE patients, revealing that lower activity was more common in the Alternative and Lectin pathways compared to the Classical pathway.
- Clinical presentation showed that disease damage correlated positively with complement pathways, particularly relating to anti-ribosomes and anti-nucleosomes antibodies, suggesting these pathways play a significant role in SLE disease characteristics.
Objectives: To evaluate the prevalence of self-perceived depression and anxiety in patients with systemic lupus erythematosus (SLE) and to explore associated factors.
Methods: Cross-sectional study of unselected patients with SLE (ACR-97 criteria) and controls with chronic inflammatory rheumatic diseases. Both completed the Hospital Anxiety and Depression Scale (HADS).
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.
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.
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 PDFWe identify an intronic deletion in that predisposes to renal injury in high risk populations through a kidney-intrinsic process. Half of all SLE patients develop nephritis, yet the predisposing mechanisms to kidney damage remain poorly understood. There is limited evidence of genetic contribution to specific organ involvement in SLE.
View Article and Find Full Text PDFArticle Synopsis
- The study aims to evaluate how different targeted therapies and other factors impact COVID-19 hospitalisation risk in patients with inflammatory rheumatic diseases.
- A cohort of 7,782 patients was analyzed, revealing that while most targeted therapies weren't linked to increased hospitalisation risk, TNF inhibitors significantly lowered it, while rituximab appeared to increase risk.
- Key demographics and comorbidities, alongside COVID-19 symptoms, also influenced hospitalisation likelihood, indicating that multiple factors play a role in patient outcomes.
Objectives: To derive and validate a definition of low disease activity (LDA) for SLE based on the SLE Disease Activity Score (SLE-DAS), in a real-life multicentre cohort of SLE patients.
Methods: Derivation was conducted using data from a monocentric cohort of SLE (Portugal), and validation was performed in a multicentre cohort (Italy, France and Spain). The Lupus Low Disease Activity State (LLDAS) was used as comparator.
Objectives: To describe the methods of the Spanish Registry of patients with idiopathic inflammatory myopathy (IIM) (Myo-Spain), as well as its strengths and limitations. The main objective of the project is to analyse the evolution and clinical management of a cohort of patients with IIM.
Methods: Observational, longitudinal, ambispective and multicentre study of a cohort of patients with IIM seen in rheumatology units in Spain.
Despite promising candidates for new therapeutic options in the treatment of systemic lupus erythematosus (SLE), many clinical trials have failed in the past few years. The disappointing results have been at least partly be attributed to trial designs. With the aim of stimulating new developments in SLE trial design, an international open space meeting was held on occasion of the European Lupus Meeting 2018 in Duesseldorf, Germany about 'What are the topics you care about for making trials in lupus more effective?'.
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- SLE (Systemic Lupus Erythematosus) significantly affects the gastrointestinal tract, with over 50% of patients reporting GI symptoms; a study analyzed data from 3658 SLE patients to understand these manifestations.
- Patients with GI damage (3.7% of the cohort) were generally older, had longer disease duration, and higher rates of complications like vasculitis and renal disease, leading to increased hospitalizations and mortality.
- The presence of GI damage correlates with worse prognosis, and higher glucocorticoid doses increase the risk, while oral ulcers may actually reduce the likelihood of developing GI damage.