5 hot-spot studies to learn about the latest clinical developments in systemic lupus. EULAR 2020.

Don't want to miss Jiemei's push? Poke the blue word "medical rheumatism and nephropathy channel" to pay attention to us and click the "··" menu in the upper right corner and select "set as star" EULAR 2020. Let's listen together! On June 3, 2020, the European annual meeting on rheumatism (EULAR) officially opened.due to the impact of the covid-19 epidemic, this meeting was held online.in the first day of the meeting, a number of scholars from all over the world shared the latest research results in related fields."rheumatism and nephropathy channel of medical circles" specially invited Zhou Yunshan, chief physician of Rheumatology and Immunology Department of people's Hospital of Peking University, to bring us wonderful report of the meeting.1 ms. Zoe Wigston, from the University of Leeds, UK, reported the association of two interferon gene marker scores with inflammatory musculoskeletal pain in lupus patients.previous studies have found that other IFN stimulating genes are more related to a variety of clinical indicators, including the prediction of the onset of SLE and the response to rituximab.to determine whether interferon gene marker score a (mainly including classic interferon stimulating genes such as ifi27, ifi44, ISG15, etc., regulated by interferon - α) and score B (including other interferon stimulating genes, such as IFIH1, lam3, etc., which are regulated by IFN - γ or other immune regulation), are related to synovitis and glucocorticoid use in lupus patients A total of 133 SLE patients with inflammatory pain were enrolled.Doppler ultrasound and IFN gene marker scores were performed at baseline, 2 weeks and 6 weeks after intravenous administration of methylprednisolone 120 mg.results IFN score B was associated with synovitis confirmed by Doppler ultrasound at baseline, but score a was not.Application of glucocorticoid had no effect on IFN gene marker score.2 ms. Jose Antonio P. Da Salva, from the Central Hospital of coimba University in Portugal, proposed a new index to evaluate the disease activity of lupus: the lupus disease activity score (sle-das, figure 1), and defined sle-das as the low disease activity state (sle-das & lt; 7 and prednisone ≤ 7.5mg / D) was compared with low disease activity status (lldas).this study was a cross-sectional study. A total of 292 lupus patients were enrolled. The results showed that the low disease activity state defined by sle-das was consistent with lldas (Cohen's kappa = 0.831, P & lt; 0.001).sle-das can be calculated by simple calculation software, and can be used to evaluate the low disease activity status of lupus patients in clinical work.Figure 1. Lupus disease activity score (sle-das) calculation interface 3. Dr. Dai Gao from the first hospital of Peking University, China, shared a real-world cohort study of lupus patients achieving low disease activity (lldas) and lupus remission definition (Doris, figure 2).218 newly diagnosed lupus patients were enrolled in this study, and the median follow-up was 4.48 years.among them, 87.2% of the patients met the lldas standard, 73.4% reached the lldas standard with daily hormone dosage ≤ 5mg (lldas5), 67.9% achieved clinical Ron T, 43.1% achieved complete ront, 10.6% achieved clinical roft, and 8.3% achieved complete roft.the median time to reach lldas was 1.4 years, and the time to reach clinical remission was nearly 2 times (median 2.6 years). the median time to complete remission was 4.7 years, and 40% of the patients with clinical remission could not achieve complete remission (i.e. serological negative). only a small number of patients can achieve drug-free remission. the presence of Raynaud's phenomenon, anemia and positive anti dsDNA at baseline is not conducive to low disease activity or remission. at baseline, hormonal shock therapy contributes to complete remission. Fig. 2. lupus low disease activity (LLDAS) and lupus remission definition (DORIS) 4 Sarah Dyball, from Manchester University, UK, compared the existing 3 lupus classification criteria in their study, and tried to diagnose lupus only with blood and immunological indicators. 227 patients with positive antinuclear antibody and at least one manifestation of connective tissue disease (including 89 cases of lupus erythematosus, 62 cases of undifferentiated connective tissue disease, 43 cases of primary Sjogren's syndrome, 25 cases of systemic sclerosis and 8 cases of inflammatory myopathy) were included in the study. the study found that slicc-12 had the best sensitivity (94%) but poor specificity (61%). The sensitivity (87%, 84%) and specificity (76%, 78%) of acr-97 and eular-19 were similar. only 33% of SLE patients would meet the eular-19 standard if only relying on blood and immune indicators (hemocytopenia, hypocomplementaemia, antiphospholipid antibody, anti dsDNA antibody and SM antibody) without considering the clinical manifestations. at the same time, only 4 / 62 patients with undifferentiated connective tissue disease and 4 / 43 patients with primary Sjogren's syndrome met the eular-19 criteria. however, 20 / 62 undifferentiated connective tissue disease and 10 / 43 primary Sjogren's syndrome met the eular-19 criteria if clinical manifestations and blood and immunological indicators were taken into account. 5 Stephane zuilly, from wil Cornell Medical Center, USA, introduced the development of new classification criteria for antiphospholipid syndrome (APS). after the investigation of clinical needs, meta-analysis, and the addition and subtraction items of questionnaire survey since 2015, the working group screened out a total of 27 indicators that may be added to the diagnostic criteria (including laboratory examination, macrovascular events, microvascular events, obstetric events, valvular heart disease and blood system abnormalities). at the current stage, the working group collected 314 potential APS cases in several centers in America and Europe, and the cases were scored by doctors interested in APS worldwide. 137 cases were rated as highly suspected APS, 177 cases were rated as "ambiguous or less likely APS". in the two groups, 27 indicators that may be added to the standard were compared. The results showed that lupus anticoagulant, anticardiolipin antibody IgG, anti β 2 glycoprotein I antibody IgG and IgM, venous thrombosis, arterial thrombosis, microvascular disease, abortion at 16-34 weeks of gestation, severe preeclampsia, severe placental insufficiency, valvular heart disease, thrombocytopenia were found; 150 × 109 / l was an indicator of highly suspected APS. next, the working group will define and weight these indicators, and verify them in different populations. the above studies mainly focus on the diagnosis and disease evaluation of systemic lupus erythematosus and antiphospholipid syndrome, including the latest progress in related fields close to clinical needs. in the follow-up meeting agenda, more new progress in the treatment of systemic lupus erythematosus and lupus nephritis will also be included. Please look forward to it.