Recent research suggests that people with lupus may benefit from a supervised program of cardiovascular training. In this study, 60 women with lupus (ages 18-55) were divided into two
groups: a training group who participated in the supervised cardiovascular training program for 60 minutes, three times a week for 12 weeks, and a comparison group who did not participate in the program. The training group showed a significant improvement of aerobic capacity as well as significant improvement in exercise tolerance, quality of life, and depression after 12 weeks.
People with lupus always should consult with their physician before beginning an exercise program.
Read the entire abstract.
The association between steroid use and osteoporosis (thinning of the bones) is well established. The widespread use of steroids to treat lupus was thought to be the cause of bone loss in people with lupus. However, new research suggests that osteoporosis in women with lupus may be associated with damage caused by the disease, unrelated to steroid therapy.
In this study, 307 women with systemic lupus were interviewed, had a physical examination, laboratory testing and bone mineral density (BMD) measurements. The average age of the women in the study was 33 years, 24 percent were African American, and 65 percent were premenopausal.
Study results showed that women with lupus who had some disease damage but no steroid treatments had similar bone density to that of women with disease damage who had used steroids.
Read the complete abstract
Women with lupus have an increased risk of heart disease that is not fully
explained by the classic risk factors. For many years, this increased risk was
thought to be caused by steroid treatments for lupus. In the general population,
insulin resistance, which can eventually lead to diabetes, is an established
risk factor for coronary heart disease (CHD). In this study, researchers compared
insulin resistance and pre-diabetes measures in people with lupus and in healthy
people, and looked at the relationship of any diabetes-related abnormalities
to another known CHD risk factor, circulating oxidized low density lipoprotein.
Low density lipoprotein is sometimes called "bad cholesterol," and
the "oxidized" form might be even worse. The study found that people
with lupus show a significant tendency to insulin resistance and pre-diabetes
(18%), even when there are no obvious signs of diabetes. The insulin resistance
in people with lupus was not strongly related to previous or current steroid
use. It was, however, associated with higher levels of oxidized "bad cholesterol."
Insulin resistance, therefore, may represent an additional heart disease risk
factor in people with lupus.
Read the entire abstract
Children with severe rheumatic diseases often require treatment with steroids, which can lead to slower growth and low bone density. Some studies have reported a beneficial effect of human growth hormone (hGH) in these patients, but mostly in trials that did not have a control group of children who did not receive hGH to compare results. Researchers in The Netherlands studied the effect of hGH on growth, bone density and body composition on 17 prepubertal rheumatic disease patients with delayed growth and/or decreased bone density, taking into account disease activity and steroid use.
In this study, ten patients received treatment with hGH for two years. Seven patients received no hGH treatment. Researchers concluded that in this study there was a significant effect on growth and body mass among children who received hGH compared to those who did not, but a longer duration of treatment might be necessary to evaluate the effect of hGH on bone density.
Read the entire abstract
Many people with lupus produce antibodies (Abs) that bind to double-stranded DNA (dsDNA).
Recent work has shown that a particular antibody can also interact with the NMDA receptor within the brain, which alerts the brain to pain in the central nervous system. This antibody appears to target particularly vulnerable cells in the hippocampus, the part of the brain responsible for learning and memory.
The nerve cells (neurons) in the brain are normally protected by a blood-brain barrier; however, a breach in the barrier's integrity exposes nerve cells to potentially harmful Abs. The researchers previously showed that mice can be induced to produce lupus-like Abs that bind both to DNA and the NMDA receptor. After treatment with a substance that impairs the bloodbrain barrier these mice are found to have damaged nerve cells and impaired memory.
Adrenaline can increase the flow of blood through the brain and lead to leaks in the blood-brain barrier. The researchers treated the mice that had the brain Abs with epinephrine, a synthetic adrenaline. Epinephrine led the mice to develop a behavioral disorder with a decreased response to fear-conditioning.
These experiments are helping to understand which brain regions are vulnerable to Abs that can harm nerves, and what sorts of problems these antibodies might cause in thinking and/or emotional behavior.
Read the complete abstract
Researchers studied antibody clusters (groups of antibodies found together in individual patients) which might be associated with certain clinical symptoms and organ damage in people with lupus. Seven autoantibodies were selected for the study: anti-double-stranded DNA (antidsDNA), anti-Sm, anti-Ro, anti-La, anti-RNP, lupus anticoagulant (LAC), and anticardiolipin antibody (aCL).
Among the 1,357 lupus patients in the study, researchers identified three distinct autoantibody groups: Cluster 1: anti-Sm and anti-RNP; Cluster 2: anti-dsDNA, anti-Ro, and anti-La; Cluster 3: anti-dsDNA, LAC, and aCL.
The researchers concluded that autoantibody clustering might be of some value to differentiate between various subsets of lupus-related symptoms, allowing prediction of what sorts of risks might be expected in patients.
Read the entire abstract
This study examined the role of gender in disease pattern and prognosis among Latin-American men with lupus. Of 1,214 lupus patients in the study, 123 (10%) were men.
When compared to women, men had a shorter delay to diagnosis, and higher incidence of fever, weight loss, high blood pressure, kidney disease, hemolytic anemia, anticardiolipin antibodies, and low complement (C3). Although not statistically significant, there was a trend to more deaths in men.
Read the complete abstract
The use of estrogen in lupus has been controversial, despite studies to suggest it might be safe for most patients. This study looked at raloxifene (Evista), a specialized type of estrogen that only acts on some of the targets for estrogen in the body, to see the drug's effects on lupus disease activity and bone density in postmenopausal women with lupus. The researchers studied 33 women who had inactive lupus and low bone density, all of whom were also receiving low-dose steroid treatment (prednisolone). The patients received either raloxifene plus calcium, or calcium only. After one year, patients on calcium alone showed a 2.6 percent decrease in the bone density in their hip and a 3.3 percent reduction in the bone density of their spine.
There was no change in bone density in the raloxifene group, suggesting that this treatment helped them to maintain the appropriate bone density after menopause. Four of the women taking raloxifene and six in the untreated group had mild to moderate lupus flares, which was not a significant difference, while none of the women in the study had severe flares. Because lupus flares are rare in postmenopausal women, the researchers note that a much larger study would be needed to identify any effect of raloxifene on disease activity in this group.
Read the entire abstract
It is known that two types of drugs, angiotensin-converting enzyme inhibitors (ACE inhibitors or ACEI) and angiotensin II receptor blockers (ARB) which control high blood pressure and treat heart disease, also reduce protein in the urine and improve kidney function in people with diabetes or other kidney diseases. However the role that these drugs might play to protect people with lupus kidney disease has not been established.
The researchers in this study investigated the effects of ACEI/ARB on protein loss and kidney function in 14 lupus patients who had persistent protein loss (>1 g/day), despite what otherwise looked like improvement of their kidney disease. Protein loss and blood protein (serum albumin) measurements showed significant improvements after six and 24 months of treatment suggesting that these drugs may also be beneficial in lupus kidney disease; however additional studies that look at larger patient groups would be needed. Read the entire abstract
The Phase II/III study will focus on the safety and efficacy of rituximab (Rituxan) compared with placebo when combined with a single stable background immunosuppressive medication in people with moderate to severe lupus. The primary efficacy endpoint of the randomized, double-blind, placebo-controlled trial will be evaluated at 52 weeks. EXPLORER is looking for participants who are currently diagnosed with SLE, are between the ages of 16 and 75, are experiencing an active disease flare, are stably using one immunosuppressive drug, and are neither pregnant nor nursing. For more information, call 1-800-597-4469 or visit this URL: http://www.clinicaltrials.gov/ct/show/NCT00137969?order=14
The safety of MMF in the long-term treatment of lupus nephritis will also be assessed. For more information, go online to www.almstudy.com.
LFA Issues RFA for Novel, Innovative Pilot Projects The LFA seeks to support novel, innovative pilot projects to forward lupus research by providing start-up funds to initiate new studies. Up to three one-year grants of $65,000 may be awarded for studies that address key understanding of lupus research issues. Research projects should either come from junior investigators without substantial funding (e.g. R01 or R01 equivalent) or established investigators with a new lupus-specific research proposal which is not or has not already been funded. Letters of Intent are due by March, 17, 2006. The complete RFA and application package are available through the LFA website at this URL: http://www.lupus.org/research/RGP.html.
Undergraduate, graduate and medical students are eligible to apply. However, preference is given to students with a college degree. Applications are due March 15; notification is expected by June 1, 2006. The program announcement and application are posted to the LFA website at this URL: http://www.lupus.org/research/student.html
TODAY Show Green Room Book Auction Raises Funds for Lupus Research The Lupus Foundation of America, Inc. (LFA) will receive $34,107 generated through the eBay auction of the NBC "TODAY's" annual Green Room Book. The funds have been designated to support medical research on lupus.
http://www.lupus.org/webmodules/articles/anmviewer.asp?a=379&z=14
New Tool Helps Beneficiaries Choose the Medicare Rx Coverage RxCompareTM is a free tool developed by Medicare Access for Patients-Rx (MAPRx)TM, a coalition of patient advocacy groups convened by the LFA. RxCompare helps users determine if they need to enroll in a Medicare drug plan and, if they do, to systematically compare the drug plans where they live and select the best option for their prescription needs. The tool works in tandem with Medicare's on-line "Prescription Drug Plan Finder" and with information available from plans or 1-800-MEDICARE. RxCompare provides worksheets for compiling and comparing key cost details and other decision factors about local plan options. In addition, it includes answers to frequently asked questions, definitions of key terms, and guidance on