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Dedicated to increasing awareness about
systemic lupus erythematosus (SLE), disease activity and related organ damage

SLE Clinical Presentation

SLE disease activity can be defined as the sum of all abnormalities due to ongoing immune inflammatory pathways involved in SLE.1 Disease activity can be assessed by clinical features (eg, arthritis and rash), serologic features (eg, decreased complement and increased anti-dsDNA) and laboratory features (eg, urinalysis and WBC).2,3

Fatigue is one of the most common clinical manifestations of SLE. Increasing fatigue is associated with increased helplessness and decreased mental and physical function. The severity of fatigue may be related to psychosocial factors and/or disease activity.4

Neuropsychiatric syndromes may also occur in patients with SLE. Symptoms may include5:

  • cognitive dysfunction
  • headache
  • depression, anxiety
  • seizures
  • psychosis
  • movement disorders

Cardiovascular events, nephritis, and osteoporosis are also of major concern for patients with SLE.6-8

Visible SLE signs include2,9,10:

  • swelling of joints
  • fever >100°F
  • hair loss
  • nose or mouth sores
  • skin rash following sun exposure
  • weight changes

Disease activity can be assessed in several ways. Some physicians use the Physicians Global Assessment (PGA) or the SELENA-SLEDAI* score to track changes in disease activity.11,12 Additional assessments include laboratory tests and subspecialist consultations as needed.2,13

While it is estimated that approximately 75% of patients with SLE have persistently active disease, not all patients are symptomatic.14,15 About 7% of patients with SLE may be clinically quiescent but still have serologically active disease.16 Therefore, even in the absence of symptoms, regular monitoring of patients with SLE is recommended.2,17

* SELENA-SLEDAI = Safety of Estrogens in Lupus Erythematosus: National Assessment Version of the Systemic Lupus Erythematosus Disease Activity Index.

Consider using tools to help your patients share their lupus symptoms. View the Lupus Checklist, a simple worksheet designed to help patients recognize and record their symptoms and other changes in their health.

LEARN MORE ABOUT SLE

This slide deck discusses the path to diagnosis of SLE, pathogenesis of the disease, impact on patients, and how to best support patients.

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CLINICAL IMPACT OF SYSTEMIC LUPUS ERYTHEMATOSUS DISEASE ACTIVITY ON LONG-TERM ORGAN DAMAGE

R. Elaine Lambert, MD, in a question and answer format.

This promotional program was developed in conjunction with and sponsored by GSK, based on an interview with R. Elaine Lambert, MD.

Dr. Lambert received a fee for participation in this program.

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What Next?

For patients with SLE, an accurate diagnosis may take years.13,14

Learn more now

References:
1. Doria A, Gatto M, Zen M, et al. Optimizing outcomes in SLE: treating-to-target and definition of treatment goals. Autoimmunity Reviews 2014;13:770-77. http://dx.doi.org/10.1016/j.autrev.2014.01.055. Accessed February 14, 2017. 2. American College of Rheumatology Ad Hoc Committee on Systemic Lupus Erythematosus Guidelines. Guidelines for referral and management of systemic lupus erythematosus in adults. Arthritis Rheum. 1999;42(9):1785-1796. http://www.ncbi.nlm.nih.gov/pubmed/10513791. Accessed February 14, 2017. 3. Fernando MMA, Isenberg DA. How to monitor SLE in routine clinical practice. Ann Rheum Dis. 2005;64:524-527. 4. Askanase A. Systemic Lupus Erythematosus (SLE): Understanding and Addressing Patient Needs. Patient Care Insights. http://www.talksle.com/pdfs/patient-care-insights
-addressing-needs-patients-sle.pdf. Accessed February 14, 2017. 5. Brey RL, Holliday SL, Saklad AR, et al. Neuropsychiatric syndromes in lupus: prevalence using standardized definitions. Neurology. 2002;58(8):1214-1220. http://www.ncbi.nlm.nih.gov/pubmed/11971089. Accessed February 14, 2017. 6. Magder LS, Petri M. Incidence of and risk factors for adverse cardiovascular events among patients with systemic lupus erythematosus. Am J Epidemiol. 2012;176(8):708-719. http://dx.doi.org/10.1093/aje/kws130. Accessed February 14, 2017. 7. Bastian HM, Roseman JM, McGwin G Jr, et al; for the LUMINA Study Group. Systemic lupus erythematosus in three ethnic groups. XII. Risk factors for lupus nephritis after diagnosis. Lupus. 2002;11(3):152-160. 8. Ramsey-Goldman R, Dunn JE, Huang C-F, et al. Frequency of fractures in women with systemic lupus erythematosus: comparison with United States population data. Arthritis Rheum. 1999;42(5):882-890. http://dx.doi.org/10.1002/1529-0131(199905)42:5%3C882::AID-ANR6%3E3.0.CO;2-C. Accessed February 14, 2017. 9. Hahn BH. Systemic lupus erythematosus. In: Fauci A, Braunwald E, Kasper DL, et al, eds. Harrison's Principles of Internal Medicine. 17th ed. New York, NY: McGraw Hill; 2008:2075-2083. 10. Ringold S, Lynm C, Golub RM. JAMA patient page. Systemic lupus erythematosus. JAMA. 2005;293(24):3130. 11. Bombardier C, Gladman DD, Urowitz MB, Caron D, Chang CH. Derivation of the SLEDAI. A disease activity index for lupus patients. The Committee on Prognosis Studies in SLE. Arthritis Rheum. 1992 Jun;35(6):630-640. 12. Lateef A, Petri M. Unmet medical needs in systemic lupus erythematosus. Arthritis Res Ther. 2012;14 Suppl 4:S4. 13. van Vollenhoven RF, Mosca M, Bertsias G, et al. Treat-to-target in systemic lupus erythematosus: recommendations from an international task force. Ann Rheum Dis. 2014;73(6):958-967. http://dx.doi.org/10.1136/annrheumdis-2013-205139. Accessed February 14, 2017. 14. Nossent J, Kiss E, Rozman B, et al. Disease activity and damage accrual during the early disease course in a multinational inception cohort of patients with systemic lupus erythematosus. Lupus. 2010;19(8):949-956. http://dx.doi.org/10.1177/0961203310366572. Accessed February 14, 2017. 15. Conti F, Ceccarelli F, Perricone C, et al. Flare, persistently active disease, and serologically active clinically quiescent disease in systemic lupus erythematosus: a 2-year follow-up study. PLoS One. 2012;7(9):e45934. 16. Steiman AJ, Gladman DD, Ibañez D, Urowitz MB. Prolonged serologically active clinically quiescent systemic lupus erythematosus: frequency and outcome. J Rheumatol. 2010;37(9):1822-1827. 17. Lam GK, Petri M. Assessment of systemic lupus erythematosus. Clin Exp Rheumatol. 2005;23(5 Suppl 39):S120-S132. http://www.clinexprheumatol.org/article.asp?a=2697. Accessed February 14, 2017.