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)

ABSTRACT: Systemic 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.

• Autores: Pons Estel, Bernando A.; Bonfa, Eloisa; Soriano, Enrique; Cardiel, Mario; Izcovich, Ariel; Popoff, Federico; Criniti, Juan M.; Vásquez Duque, Gloria María; Massardo, Loreto; Duarte, Margarita; Barile Fabris, Leonor A.; García, Mercedes A.; Amigo, Mary C.; Espada, Graciela; Catoggio, Luis J.; Inoue, Emilia; Levy, Roger; Acevedo, Eduardo M.; Chacón, Rosa; Galarza Maldonado, Claudio M.; Iglesias Gamarra, Antonio J.; Molina, José Fernando; Neira, Oscar; Silva, Clóvis A.; Vargas Peña, Andrea; Gómez Puerta, José Alfredo; Scolnik, Marina; Pons Estel, Guillermo J.; Ugolini Lopes, Michelle R.; Savio, Verónica; Drenkard, Cristina; Alvarellos, Alejandro J.; Ugarte Gil, Manuel F.; Babini, Alejandra; Cavalcanti, André; Cardoso Linhares, Fernanda Athayde; Haye Salinas, María Jezabel; Fuentes Silva, Yurilis J.; Montandon de Oliveira e Silva, Ana Carolina; Eraso Carnica, Ruth María; Herrera Uribe, Sebastián; Gómez Martín, Diana; Robaina Sevrine, Ricardo; Quintana, Rosana M.; Gordon, Sergio; Fragoso Loyo, Hilda; Rosario, Violeta; Saurit, Verónica; Appenzeller, Simone; Torres dos Reis Neto, Edgard; Cieza, Jorge; González Naranjo, Luis Alonso; González Bello, Yelitza C.; Collado, María Victoria; Sarano, Judith; Retamozo, Soledad; Sattler, María E.; Gamboa, Rocío V.; Cairoli, Ernesto; Conti, Silvana M.; Amezcua Guerra, Luis M.; Silveira, Luis H.; Borba, Eduardo F.; Pera, Mariana A.; Alba Moreyra, Paula B.; Arturi, Valeria; Berbotto, Guillermo A.; Gerling, Cristian; Gobbi, Carla A.; Gervasoni, Viviana L.; Scherbarth, Hugo R.; Tavares Brenol, João C.; Cavalcanti, Fernando; Lavras Costallat, Lilian T.; Da Silva, Nilzio A.; Monticielo, Odirlei A; Parente Costa Seguro, Luciana; Xavier, Ricardo M.; Llanos, Carolina; Montúfar Guardado, Rubén A.; Garcia de la Torre, Ignacio; Pineda, Carlos; Portela Hernández, Margarita; Danza, Alvaro; Guibert Todelano, Marlene; Reyes, Gil; Acosta Colman, Maria Isabel; Aquino, Alicia M.; Mora Trujillo, Claudia S.; Muñoz Louis, Roberto; García Valladares, Ignacio; Celeste Orozco, María; Burgos, Paula I.; Betancur, Graciela V.; Alarcón, Graciela S.
• Tipo de recurso: Article of investigation
• Fecha de publicación: 2018
• Institución: Universidad de Antioquia
• Repositorio: Repositorio UdeA
• Idioma: eng
• OAI Identifier: oai:bibliotecadigital.udea.edu.co:10495/25990
• Acceso en línea: http://hdl.handle.net/10495/25990
• Palabra clave: Lupus Eritematoso Sistémico; Lupus Erythematosus, Systemic; Terapéutica; Therapeutics
• Rights: openAccess
• License: http://creativecommons.org/licenses/by-nc/2.5/co/