Produção Nacional
Revisado por pares
First Latin American clinical practice guidelines for the treatment of systemic lupus erythematosus: Latin American Group for the Study of Lupus (GLADEL, Grupo Latino Americano de Estudio del Lupus )–Pan-American League of Associations of Rheumatology (PANLAR)
2018; BMJ; Volume: 77; Issue: 11 Linguagem: Inglês
10.1136/annrheumdis-2018-213512
ISSN1468-2060
AutoresBernardo A. Pons‐Estel, Eloísa Bonfá, Enrique R. Soriano, Mario H. Cardiel, Ariel Izcovich, Federico Popoff, Juan Criniti, Gloria Vásquez, Loreto Massardo, Margarita Duarte, Leonor Barile-Fabris, Mercedes García, Mary‐Carmen Amigo, Graciela Espada, Luís J. Catoggio, Emília Inoue Sato, Roger A. Levy, Eduardo M. Acevedo‐Vásquez, R. Chacón, Claudio Galarza-Maldonado, Antonio J. Iglesias Gamarra, José Fernando Molina, Óscar Neira, Clóvis A. Silva, Andrea Vargas Peña, José A. Gómez‐Puerta, Marina Scolnik, Guillermo J. Pons‐Estel, Michelle Remião Ugolini‐Lopes, V. Savio, Cristina Drenkard, Alejandro Alvarellos, Manuel F. Ugarte‐Gil, Alejandra Babini, André Cavalcanti, Fernanda Athayde Cardoso Linhares, María Jezabel Haye Salinas, Yurilís Fuentes-Silva, Ana Carolina Montandon de Oliveira e Silva, Ruth Eraso, Sebastián Herrera, Diana Gómez-Martı́n, Ricardo Robaina Sevrini, Rosana Quintana, Sergio Gordon, Hilda Fragoso-Loyo, V. Rosario, Verónica Saurit, Simone Appenzeller, Edgard Torres dos Reis Neto, Jorge Cieza-Calderón, Luis Alonso González Naranjo, Yelitza C González Bello, María Victoria Collado, Judith Sarano, Soledad Retamozo, M. Emilia Sattler, Rocío V. Gamboa‐Cárdenas, Ernesto Cairoli, Silvana Conti, Luís M. Amezcua‐Guerra, Luis H. Silveira, Eduardo Ferreira Borba, Mariana Pera, Paula B Alba Moreyra, Valeria Arturi, Guillermo Berbotto, Cristian Gerling, Carla Gobbi, Viviana Gervasoni, Hugo R. Scherbarth, João Carlos Tavares Brenol, Fernando Cavalcanti, Lílian Tereza Lavras Costallat, Nilzio A Da Silva, Odirlei André Monticielo, Luciana Parente Costa Seguro, Ricardo Machado Xavier, Carolina Llanos, Rubén A. Montufar Guardado, Ignacio García‐De La Torre, Carlos Pineda, Margarita Portela Hernández, Álvaro Danza, Marlene Guibert-Toledano, Gil Reyes, I. Acosta-Colman, Alicia Aquino, Claudia S Mora-Trujillo, Roberto Muñoz-Louis, Ignacio García valladares, María Celeste Orozco, Paula I. Burgos, Graciela V Betancur, Graciela S. Alarcón,
Tópico(s)Atherosclerosis and Cardiovascular Diseases
ResumoSystemic lupus erythematosus (SLE), a complex and heterogeneous autoimmune disease, represents a significant challenge for both diagnosis and treatment. Patients with SLE in Latin America face special problems that should be considered when therapeutic guidelines are developed. The objective of the study is to develop clinical practice guidelines for Latin American patients with lupus. Two independent teams (rheumatologists with experience in lupus management and methodologists) had an initial meeting in Panama City, Panama, in April 2016. They selected a list of questions for the clinical problems most commonly seen in Latin American patients with SLE. These were addressed with the best available evidence and summarised in a standardised format following the Grading of Recommendations Assessment, Development and Evaluation approach. All preliminary findings were discussed in a second face-to-face meeting in Washington, DC, in November 2016. As a result, nine organ/system sections are presented with the main findings; an 'overarching' treatment approach was added. Special emphasis was made on regional implementation issues. Best pharmacologic options were examined for musculoskeletal, mucocutaneous, kidney, cardiac, pulmonary, neuropsychiatric, haematological manifestations and the antiphospholipid syndrome. The roles of main therapeutic options (ie, glucocorticoids, antimalarials, immunosuppressant agents, therapeutic plasma exchange, belimumab, rituximab, abatacept, low-dose aspirin and anticoagulants) were summarised in each section. In all cases, benefits and harms, certainty of the evidence, values and preferences, feasibility, acceptability and equity issues were considered to produce a recommendation with special focus on ethnic and socioeconomic aspects. Guidelines for Latin American patients with lupus have been developed and could be used in similar settings.
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