Welcome to Rheum for Improvement, a website for people with lupus and the health professionals who care for them.
Reducing risk of hydroxychloroquine (Plaquenil) retinal toxicity
Hydroxychloroquine (HCQ) is used for its anti-inflammatory properties but it can cause irreversible damage to the retina when taken in high does or if used for many years. A recent study showed that retinal toxicity is not as rare as once believed. It affects about 7.5% of users, however, this number represents those with long exposure to HCG in too high a dose. Awareness by health professionals of how to screen patients and calculate proper dose can make HCQ safer than ever. Keeping daily doses below 5.0mg/kg of regular body weight (not ideal body weight) and following vision exam guidelines can reduce toxicity risk. (Read more...)
Low vitamin D levels associated with high disease activity
While some recent studies have questioned the usefulness of vitamin D in preventing or improving certain conditions, a new study by Australian investigators from Monash University found a significant association between low vitamin D levels in patients with lupus and a higher level of disease activity.Likewise, an increase in vitamin D level was associated with reduced activity over time. Read more...
Past news flashes
Marijuana not helpful for patients with SLE
Two presentations at the annual American College of Rheumatology meeting held last week in Boston revealed how unhelpful marijuana is for patients with chronic rheumatologic pain. Among marijuana users with lupus, researchers found a 39% increase in neuropsychiatric SLE and an 85% increase in end-stage renal disease (ESRD) requiring dialysis. Data analysis showed that an amazingly increased rate of non-adherence to recommended therapy (95%, compared with only 3% among nonusers), which explained the increase in ESRD. They also reported a disturbing although non-significant increase in mortality of 40% among the pot users. Investigators concluded these findings do not a beneficial role for medical marijuana in lupus. Read more here.
American College of Rheumatology extends lupus initiative
The American College of Rheumatology announced the $2 million, one-year extension of its initiative to eliminate health disparities in lupus. The extension is supported by a grant from the U.S. Department of Health and Human Services, Office of Minority Health in collaboration with the Office on Women's Health and Office of the Surgeon General. The grant will allow continued nationwide access to educational resources that improve the diagnosis and treatment of lupus and reduce associated health disparities. Read more here.
Vaccine for lupus?
Researchers at Northwestern University are looking at how a vaccine may help normalize immune function in patients with lupus. It also may help family members of people with lupus and others at high risk for lupus as predicted by genetic and other biomarkers. Read more here.
Fast track for lupus research
The National Institutes of Health (NIH) has awarded grants to 11 research groups across the United States to establish the Accelerating Medicines Partnership in Rheumatoid Arthritis and Lupus (AMP RA/Lupus) Network. Launched in February of this year, the NIH AMP Program is a public-private partnership developed to transform the current model for identifying and validating the most promising biological targets for the development of new drugs and diagnostics. Read more here.
Immunotherapy for lupus
Researchers in the UK are working to develop immunotherapy for lupus, similar to the desensitization therapy used for allergies. It is hoped that this therapy will create tolerance by switching T helper cells into T regulatory cells. Read more here.
How diet may trigger flares
Dr. Bruce Richardson, recipient of the second Lupus Insight Prize, is about to begin studies to confirm whether environmental sources such as sunlight and poor diet truly disrupt T-cell signaling in lupus patients. Click here to listen to the brief recorded interview where Dr. Richardson describes the history of this research and reveals its direct implications for patients with lupus now.
Personalized treatment for lupus
Researchers at the Centre for Personalised Immunology
at the John Curtin School of Medical Research in Australia sequenced the genes
of a young girl with lupus who had suffered a stroke at age 4. This allowed
them to identify a specific gene variant she carried. It is possible
that individual causes of lupus can be discovered by sequencing patients’ DNA potentially
allowing doctors to target specific treatments to individual patients. Read more here.
Researchers reported in the August 2014 issue of Arthritis
Care & Research that
patients with lupus who had the highest levels of Vitamin D3 as measured by
25(OH)D, which is the most reliable tests for Vitamin D levels, were less
likely to experience high blood pressure and elevated cholesterol, as well as
being more likely to have lower lupus disease activity scores and C-reactive
protein levels, an important biomarker for inflammation, when compared to lupus
patients with lower vitamin D3 levels. This study showed an association with
vitamin D3 levels, not a cause and effect, but the association was
statistically significant. For some individuals with lupus, maintaining optimal 25(OH)D
levels may be helpful in in managing their disease. Read more here.
at the European League Against Rheumatism Annual Congress (EULAR 2014) reported
that the majority of lupus patients in remission may be able to successfully
stop immunosuppressant therapy without triggering a flare of their disease.
Read more here.