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Background
Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease characterized by having varying clinical presentation, severity, unpredictable course as well as outcomes. Recent disease-modifying conventional and biologic agents have enhanced rates of attaining both short- and long-term management goals, including minimizatio...
Context in source publication
Context 1
... recommendations formulated to answer the key clinical questions are listed below. The mean level of agreement between the members of the expert panel, percentage of agreement, the level of evidence (LOE), as well as grades of recommendations are mentioned under each section. An algorithm of these recommendations is demonstrated in Fig. 2. Figure 3 shows summary of the recommended treatment of specific organ system involved in SLE, whereas Fig. 4 shows suggested management approach of acute emergencies in ...
Citations
... Applying alternating heat and cold therapies and distraction techniques can alleviate pain during flares. Avoiding excess joint-straining activities, pacing activity throughout the day, and scheduling planned rest periods are also recommended [30][31][32][33]. ...
Background: Lupus osteoarthritis is a disabling complication of systemic lupus erythematosus (SLE) caused by persistent inflammation and biomechanical factors. The complex pathogenesis and heterogeneous clinical course pose management challenges.
Purpose: To review the etiology, clinical features, treatment, and prognosis of lupus osteoarthritis.
Main body: Lupus osteoarthritis stems from immune complex deposition, autoantibodies, and cytokines that damage joint tissues. Mechanical insultscoupled with altered joint biomechanics accelerate degeneration. The hands, wrists, and knees are most frequently involved, causing pain, stiffness, and reduced mobility. Radiographic hallmarks include joint space narrowing, periarticular osteopenia, and erosions. Composite tools like SLEDAI are used to quantify disease activity. Cardiovascular disease, osteoporosis, and infections are common comorbidities. Despite improved therapies, many patients develop disabling erosive arthritis within years of lupus diagnosis. Treatment entails lifestyle modification, analgesics, antimalarials, corticosteroids, immunosuppressants, injections, and surgery as needed. Emerging biologics, regenerative strategies, and precision medicine approaches tailored to molecular profiling offer promising directions to improve long-term outcomes. However, more research is required to halt joint damage and restore mobility in this challenging complication of SLE.
Conclusion: Lupus osteoarthritis remains a major contributor to morbidity in SLE warranting further research into pathogenetic mechanisms, predictive biomarkers, and personalized therapies to prevent irreversible joint damage.
Lupus remains a disease with a low prioritisation in the national agendas of many countries in Latin America, the Middle East, and Asia-Pacific, where there is a dearth of rheumatologists and limited access to new or even standard lupus treatments. There is thus an important need for education, advocacy, and outreach to prioritise lupus in these regions to ensure that patients receive the care they need. This article reviews some of the specific challenges facing the care and management of people with lupus in these regions and suggests strategies for improving patient outcomes. Specifically, we review and discuss (with a focus on the aforementioned regions) the epidemiology of lupus; economic costs, disease burden, and effects on quality of life; barriers to care related to disease assessment; barriers to effective treatment, including limitations of standard treatments, high glucocorticoid use, inadequate access to new treatments, and low adherence to medications; and strategies to improve lupus management and patient outcomes. We hope that this represents a call to action to come together and act now for the lupus community, policymakers, health authorities, and healthcare professionals to improve lupus management and patient outcomes in Latin America, the Middle East, and Asia-Pacific.
