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  1. January 16, 2020 The Lupus Research Alliance has invested millions in research to get us to the point we’re at with potential new treatments for LN. We are proud to share what just ten of our funded scientists are doing right now to discover what causes lupus nephritis and how it can be better diagnosed, monitored and treated. With our largest grant, the Distinguished Innovator Award, Nir Hacohen at Broad Institute is studying which specific cells are responsible for injuring the kidneys of people with lupus. His aim is to provide new targets for treatments that prevent this damage and a way to predict which patients will respond to which treatments. Another Distinguished Innovator awardee, Shu Man Fu at University of Virginia, is looking at the protein C1q as a culprit in promoting kidney failure and determining if measuring the levels of this protein can help diagnose lupus nephritis and monitor response to treatment. Vicki Kelley at Harvard Medical School has discovered a master switch, a protein Ptprz, that turns on kidney inflammation and her funded study will determine if turning off this switch can protect against damage. Next step would be to develop drugs that can flip the switch. Janos Peti-Peterdi at University of Southern California invented a highly sensitive microscope to examine kidneys of animals with lupus in fine detail and with his LRA grant will use that technology to determine what goes wrong with the kidneys and how they can be repaired. LRA is supporting the work of Anne Davidson at The Feinstein Institute for Medical Research to illuminate how lupus leads to kidney damage and why the disease is more common in women than in men. Erika Boesen at University of Nebraska is studying if a newly discovered type of cell death called ferroptosis contributes to kidney damage by promoting the inflammation that characterizes lupus nephritis. At University of Michigan, Jason Knight is mapping out how turning off a protein called elastase could prevent kidney damage and other dangerous complications. Laurence Morel, University of Florida is testing in lupus models combinations of drugs like the approved diabetes treatment metformin that reduce sugar levels can slow or reverse kidney damage. Vipin Kumar at University of California San Diego is testing a novel hypothesis backed by his own preliminary data to explore a drug already used to fight tropical parasites as a potential oral medication to prevent and treat kidney damage in lupus. Jeremy Tilstra at University of Pittsburgh is figuring out how to exhaust T cells so they are too tired to attack the kidneys and other organs. With your help, we look forward to funding more studies in 2020 that can crack the underlying cause of lupus nephritis with the aim to prevent and reverse disease in the future. https://www.lupusresearch.org/lra-uncovering-what-causes-lupus-nephritis-to-improve-treatment/
  2. January 16, 2020 Up to half of people with lupus will have lupus nephritis – damage to the kidneys that affects the ability to clear the body of wastes and toxins. In 2020, we expect to see significant progress in new drug development for lupus and lupus nephritis in particular with submissions for FDA approval in progress and many opportunities to join studies exploring other potential treatments! Two companies – GSK and Aurinia Pharmaceuticals – expect to go to the U.S. Food and Drug Administration (FDA) for approval of their drugs to treat lupus nephritis based on positive Phase III trial results with Benlysta® (belimumab) and voclosporin respectively. Two new Phase III trials are starting up to test potential treatments – Gazyva® (obinutuzumab) and secukinumab. Two potential lupus nephritis treatments – Gazyva and itolizumab – are on an accelerated track for development thanks to special designations by the FDA. Plus two Phase III trials and several Phase 2 trials for lupus nephritis are already underway. https://www.lupusresearch.org/lra-shares-excitement-for-whats-ahead-in-lupus-nephritis/
  3. December 17, 2019 The Lupus Research Alliance is thrilled to share exciting news from GSK that Benlysta (belimumab) demonstrated positive clinical trial results in treating lupus nephritis (LN), a common complication of lupus causing inflammation of the kidneys that can result in end-stage kidney disease. Called BLISS-LN, this Phase 3 trial is the largest one ever conducted among patients with lupus nephritis and paves the way for a new treatment for this disease. Although belimumab is already approved by the U.S. FDA to treat systemic lupus erythematosus (SLE), it had not been tested in patients specifically for lupus nephritis and has not yet been approved for this use. The BLISS-LN trial is the last stage in clinical development before GSK submits its data with a formal request for the FDA to approve the drug as a new treatment for lupus nephritis. The company expects to file with the FDA in the first half of 2020. Kenneth M. Farber, President and CEO of the Lupus Research Alliance said: “We are very gratified that at long last additional treatment options may be emerging for lupus nephritis. Belimumab is the only drug specifically developed and approved for lupus in decades, and the fact that it has shown benefit, not only for generalized SLE, but also now for lupus nephritis, is great news. GSK has long been a terrific partner to the Lupus Research Alliance, and we extend our congratulations as well as appreciation to GSK, to the investigators who enrolled patients in the study, and especially to the people with lupus who generously participated.” As background, belimumab, like all drugs reviewed by the FDA, go through extensive clinical trials to test for safety and efficacy. Phase 1 studies test a drug’s safety in a small number of healthy people and establish dosing, and Phase 2 studies test the drug’s effectiveness in a patients and monitor safety. Phase 3 studies test the drug in a large group of patients with randomized, double-blinded trial designs. That means people are randomly selected to receive the drug being tested or placebo and, no one knows who received what until the end of the study. Phase 3 studies compare the new treatment plus standard of care (the treatment most accepted in medical practice) versus placebo plus standard of care. Companies submit filings of their data to the FDA for review after the Phase 3 trials are completed. “We encourage people with lupus and their families to visit our website LupusTrials.org and learn about clinical research. Talk to your doctor and see if there’s a study that’s right for you. Your participation is critical – we can’t deliver new treatments without your help,” ended Ken Farber. Read Announcement from GSK https://www.lupusresearch.org/new-phase-3-study-shows-positive-results-for-benlysta-in-lupus-nephritis/
  4. December 18, 2019 The Lupus Research Alliance (LRA) welcomes additional positive results published today in the New England Journal of Medicine online edition from AstraZeneca’s Phase 3 TULIP-2 trial studying the investigational biologic anifrolumab as a treatment for systemic lupus erythematosus (SLE or lupus). The new study provides further details showing that anifrolumab, which targets type I interferon, met its primary endpoint to significantly lessen disease activity. Of those treated with anifrolumab, 47.8 percent responded to treatment compared with 31.5 percent of those given a placebo. Kenneth M. Farber, President and CEO of the Lupus Research Alliance commented, “We are finally seeing the light at the end of the tunnel with this and other Phase 3 trials delivering the promise of much-needed new therapies for people with lupus. The LRA is particularly proud to see decades of work by our funded scientists on understanding the type I interferon pathway lead to the development of anifrolumab as a potential new treatment.” Anifrolumab an Outcome of Early Interferon Research Anifrolumab works by disrupting a group of proteins produced by the immune system called type I interferons that promote inflammation. Research has shown that 30-50 percent of adults and most children with lupus have high interferon levels. The Lupus Research Alliance has played a key role in unraveling the role of interferon in lupus over the past two decades. Principal investigator and author of the NEJM paper Professor Eric Morand of Monash University in Australia commented, “As an LRA-funded researcher I am both humbled and very proud to be involved in this landmark program, and so happy to see years of collective work on the IFN pathway by scientists all around the world formally validated in human SLE. It is a major validation of the scientific process and of translational research, as well as potentially a breakthrough new medicine for lupus. I hope the major learnings on trial endpoints from this program can help other programs advance towards approval.” “The Lupus Research Alliance and its legacy organizations have sponsored nearly two dozen studies on type I interferons, including work that identified a unique combination of genes that is switched on in the blood of lupus patients,” Mr. Farber said. “The LRA is particularly proud to see decades of work by our funded scientists on understanding the type I interferon pathway lead to the development of anifrolumab as a potential new treatment.” The Journal featured an accompanying editorial by long-time LRA Scientific Advisory Board member Dr. Jane Salmon, Hospital for Special Surgery and Weill Cornell Medicine, and LRA-funded investigator and reviewer Dr. Timothy Niewold, Colton Center for Autoimmunity, NYU School of Medicine. Anifrolumab Shows Promise for Reducing Disease Activity and Flares In TULIP-2, anifrolumab met its primary endpoint which is the most important result that is measured at the end of the study to see if the drug worked. Treatment with anifrolumab resulted in significant and meaningful reduction in disease activity in all organs with no new flares as measured by a standard tool called the British Isles Lupus Assessment Group (BILAG)-based Composite Lupus Assessment (BICLA). Of those treated with anifrolumab, 47.8% of patients responded to treatment compared with 31.5 who received placebo. The rate of flares was also somewhat lower among those treated with anifrolumab. The study also succeeded in meeting key secondary endpoints which measure other effects of the drug: 51.5% of those treated with anifrolumab reduced doses of the steroid prednisone versus 30.2% taking placebo. According to standard measurement tool CLASI, 49% of patients showed improvement in severity and degree of skin damage compared with 25.0% of those on placebo. No new information on safety was seen. Among patients on anifrolumab, 7.2% developed herpes zoster versus 1.1 percent of those given placebo. Less adverse events occurred in the anifrolumab group (8.3%) than the 17.0% of people in the placebo group. Also, more people given placebo discontinued the trial (7.1%) than the 2.8% on anifrolumab. One person in the anifrolumab group died from pneumonia. Click here for full background on Type I Interferon in lupus. https://www.lupusresearch.org/more-positive-results-on-anifrolumab-for-lupus-published-in-new-england-journal-of-medicine/
  5. January 6, 2020 New research published in Arthritis and Rheumatology shows that peripheral nervous system (PNS) disease is an important part of neuropsychiatric lupus with significant effects on quality of life. The peripheral nervous system is the network that sends signals between the brain and spinal cord (the central nervous system) with all the other parts of the body. Many of the scientists who participated in this study are part of the leadership of the LRA affiliate Lupus Therapeutics and its Lupus Clinical Trials Network (LuCIN). Conducted at research centers throughout the world, the study assessed 1,827 people with lupus every year over an average of 7.6 years for the frequency of 19 neuropsychiatric events, including seven types of PNS disease. The researchers also measured SLE disease activity, organ damage, and autoantibodies, as well as outcomes as reported by both patients and physicians. Nearly 8 percent of participants had PNS events. The most common PNS events included three types of neuropathy – a disorder that causes nerve damage. Of those with PNS events, 41.0 percent experienced peripheral neuropathy; 27.3 percent had mononeuropathy, and 24.2 percent had cranial neuropathy Peripheral neuropathy refers to the many conditions that involve damage to the peripheral nervous system. Mononeuropathy is a type of damage to a nerve outside the brain and spinal cord while cranial neuropathy refers to damage to nerves in the brain or brainstem People with periphereal neuropathy scored significantly lower than those who had no nerve damage on standard tools that measure physical and mental function. Most of the neuropathies resolved or improved over time. Study authors concluded: “PNS disease is an important component of total NPSLE and has a significant negative impact on health‐related quality of life. The outcome is favorable for most patients, but our findings indicate that several factors are associated with longer time to resolution.” https://www.lupusresearch.org/lupus-has-some-nerve-shows-large-international-study/
  6. January 7, 2020 2019 was a phenomenal, breakthrough year for lupus research on both the clinical development and basic science fronts. The Lupus Research Alliance (LRA) is incredibly proud that every new discovery leading to a brand new medicine for lupus had its origin in work funded by LRA years ago. The past 12 months delivered many exciting “firsts” for lupus — three positive Phase III clinical trials, Fast Track and Breakthrough Therapy designations from the U.S. Food and Drug Administration including one in lupus nephritis (a serious form of lupus affecting the kidneys), and the first treatment approved for pediatric lupus, among other developments. Watch this video to hear the highlights from LRA President & CEO Kenneth Farber while Chief Scientific Officer Dr. Teodora Staeva describes major break throughs in basic research science supported by the LRA. 2019 Was a Year of Many “Firsts” in Lupus Drug Development First Positive Phase 3 Lupus Results in 8 Years — Phase 3 TULIP-2 trial demonstrated the effectiveness of Astra Zeneca’s treatment anifrolumab in reducing lupus disease activity. The LRA has supported numerous studies identifying and unraveling the type I interferon pathway that anifrolumab targets. First Positive Phase 3 Data in Lupus Nephritis — Lupus nephritis, which affects the kidneys, is one of the most dangerous forms of lupus. A late stage trial (AURORA) conducted by Aurinia affirmed the safety and effectiveness of voclosporin. If approved by the FDA, this would be the first medicine specifically approved for this form of lupus. Because of the great need for a new treatment, the company received Fast Track designation from the U.S. FDA. First and Only Lupus Treatment Approved for Use in Children — Benlysta (belimumab) was approved by the U.S. FDA to treat children with lupus who are five years old or above. Pediatric lupus typically hits children harder than adults and comes with extra health issues since children are affected by the disease longer, impacting organ damage. First Breakthrough Therapy Designation for Gazyva Phase 2 Trials Show Effective in Treating Proliferative Lupus Nephritis, the Most Severe Form of Lupus Nephritis – The Phase 2 NOBILITY trial, conducted by Genentech, demonstrated the effectiveness of Gazyva® (obinutuzumab) in combination with mycophenyolate mofetil in treating proliferative lupus nephritis, the most severe form of lupus nephritis that affects the kidneys. The FDA recently granted obinutuzumab Breakthrough Therapy Designation which aims to speed up the development and review of drugs which may demonstrate substantial improvement over available therapy. First Promising, Phase 2 Trial Demonstrates Effectiveness of a Second Interferon Inhibitor — Positive Phase 2 trial results for Biogen’s type I interferon inhibitor BIIB059 demonstrated that it met clinical endpoints in patients with cutaneous lupus (skin related lupus) as well as in systemic lupus. Second Potential Lupus Nephritis Drug Fast Tracked by FDA — A new drug in development by Equillium for lupus nephritis, itolizumab, was just granted Fast Track Designation by the U.S. FDA. The LRA was involved in the design of the clinical trial through its affiliate Lupus Therapeutics and enlisted its patient advisory board to provide the patient perspective on clinical trial education materials. 2019 Discoveries that May Advance New Treatments and a Cure Evidence that Diet May Offer a Treatment — Pieces of bacteria that escape from the intestines may trigger lupus and associated disease flares in some patients, according to a new study led by LRA-grantee Dr. Gregg Silverman. These findings may allow disease treatment with probiotics or diets that alter the mix of bacterial species in the intestines. In addition, a study partly funded by an LRA grant to Dr. Martin Kriegel showed how a diet of high fiber may suppress harmful bacteria and enrich good bacteria in the gut microbiome. Novel Research on Biomarkers is Emerging — Novel research on biomarkers or molecules in the urine, skin and blood in lupus could minimize invasive kidney biopsies. This groundbreaking research is emerging from the Accelerating Medicines Partnership, a RA/SLE initiative involving the NIH, FNIH, industry and LRA. New Targets for Drug Development — Researchers partly funded by the LRA have found possible new targets for drugs to treat lupus after discovering that stopping a molecule BRISC from connecting to another molecule SHMT2 can reduce inflammation. Back to the Future with B Cells — Depleting the number of harmful B cells with a novel immunotherapy that employs modified T cells called CAR T cells may offer an effective strategy to treat lupus, according to results of a study led by LRA-grantee Dr. Marko Radic. These findings offer a renewed optimism for the elimination of B cells to provide a therapeutic option in lupus and pave the way for clinical research to test this new approach. Why the Immune System Goes on the Attack — A new study partly funded by the LRA may help explain how the immune system attacks patients’ DNA in lupus. Together with the laboratory of Dr. David Raulet, Dr. Joshua Woodward and his colleagues discovered a protein door in cells that allows messenger molecules that may promote these attacks to spread. The Lupus Research Alliance is the world’s leading private funder of lupus research, created to improve treatments for lupus while advancing toward a cure. We believe that scientific research is the most powerful way we can improve the lives of people living with lupus, today and over the long term. By pushing the limits of scientific exploration and shepherding new discoveries into potential treatments, we aim to seize every opportunity that will help ease the burden of people living with this difficult disease. As part of the organization’s commitment to advance lupus research and find effective and safer treatments for people living with lupus, the Lupus Research Alliance established Lupus Therapeutics. As the administrative and fiscal entity of the only Lupus Clinical Investigators Network (LuCIN), Lupus Therapeutics manages the Alliance’s clinical trial programs. LuCIN is comprised of more than 200 clinician-scientists at 57 academic medical centers and more than 20,000 active lupus patients. Supported by the Lupus Research Alliance and Lupus Therapeutics, LuCIN scientists work collaboratively to identify potentially transformative treatments and conduct related clinical trials. The LRA celebrates this year’s achievements and looks forward to continued positive developments in 2020. https://www.lupusresearch.org/lra-celebrates-major-research-breakthroughs-in-2019/
  7. JANUARY 8, 2020 Using glucocorticoids to treat inflammation in systemic lupus erythematosus (SLE) was associated with organ damage in patients without active disease, a large study found. These findings draw attention to the possible harmful effects of glucocorticoids — a type of corticosteroid hormone — and indicate that these therapies should be avoided by people with SLE when possible, the investigators said. The study, “Factors associated with damage accrual in patients with systemic lupus erythematosus with no clinical or serological disease activity: a multicentre cohort study,” was published in the journal The Lancet Rheumatology. Glucocorticoids such as prednisone are prescribed for patients with active disease due to their immunosuppressive and anti-inflammatory properties. While glucocorticoids work quickly to reduce inflammation, extended use has been associated with organ damage. This makes it difficult to determine if such damage seen in people with SLE is caused by active disease or the use of these treatments. To better understand the source of organ damage in SLE patients on glucocorticoids, researchers from 13 centers collaborated to determine if these medications also are associated with organ damage in SLE patients without active disease. The 13 centers were located in Australia, Indonesia, Japan, Malaysia, the Philippines, Singapore, Taiwan, and Thailand. Adults with SLE were identified from the Asia-Pacific Lupus Collaboration — a large, international partnership of lupus clinicians and researchers. Among the 1,707 patients recruited, 1,591 (93.2%) were women. Participants’ median age was 29 years and median SLE disease duration was 8 years. Clinical information was collected at the study’s start. Follow-up visits were conducted at least once every six months for a median follow-up period of 2.2 years. Disease activity was determined using the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K), a tool based on 24 factors of disease activity in nine organ systems. A score of 0 in SLEDAI-2K represented no disease activity. Clinicians collected information on prednisolone use at each visit. A Physician Global Assessment (PGA) was determined with a scale from 0 — for no disease activity — to 3, for maximally active disease. Organ damage was assessed using the Systemic Lupus International Collaborating Clinics Damage Index (SDI) at a minimum of one follow-up visit. The results showed that 709 patients (41.5%) had irreversible organ damage at the start of the study (baseline). Over the study period, increased organ damage was reported in 255 participants (14.9%). The factors linked to organ damage included previous damage, SLEDAI-2K score (disease activity over time), the mean PGA score, current smoking, and both age and disease duration at study enrollment. Interestingly, people of Asian ethnicity showed protection against accumulation with organ damage compared with non-Asians. However, organ damage was significantly associated with use of prednisolone, and both the mean dose and cumulative amount taken. During the study’s course, 157 patients (9.2%) showed no signs of disease activity. Yet, irreversible organ damage was reported in 21 (13.4%) of these participants. This was a similar rate compared with the overall study group, the researchers noted. These findings support the link between glucocorticoids and damage accumulation in SLE, with a 14% increase in the risk of organ damage for each 1 mg increase in the mean daily dose of prednisolone, the scientists said. While most patients were taking prednisolone during the study period, 302 (17.7%) participants had no exposure to oral glucocorticoids. Of these, 108 (35.8%) had organ damage before the study, and 31 (10.3%) developed such damage over the study period. This damage was linked to age, disease duration, and PGA score. “These findings add evidence in support of the harmful effects of glucocorticoids in SLE,” the team said. “In the absence of more effective and safer treatments for SLE, glucocorticoid use remains essential in patients with significant disease activity. However, these findings suggest that unnecessary use of glucocorticoids should be avoided in the management of the disease where possible,” the investigators added. Steve Bryson PhD Steve holds a PhD in Biochemistry from the Faculty of Medicine at the University of Toronto, Canada. He worked as a medical scientist for 18 years, within both industry and academia, where his research focused on the discovery of new medicines to treat inflammatory disorders and infectious diseases. Steve recently stepped away from the lab and into science communications, where he’s helping make medical science information more accessible for everyone. Fact Checked By: Jose Marques Lopes, PhD José is a science news writer with a PhD in Neuroscience from Universidade of Porto, in Portugal. He has also studied Biochemistry at Universidade do Porto and was a postdoctoral associate at Weill Cornell Medicine, in New York, and at The University of Western Ontario in London, Ontario, Canada. His work has ranged from the association of central cardiovascular and pain control to the neurobiological basis of hypertension, and the molecular pathways driving Alzheimer’s disease. https://lupusnewstoday.com/2020/01/08/glucocorticoids-use-linked-organ-damage-in-sle/
  8. The U.S. Food and Drug Administration (FDA) has granted fast track designation to itolizumab as a potential therapy for lupus nephritis, a common and serious complication of systemic lupus erythematosus (SLE) that can lead to kidney failure. This designation is given to compounds that show considerable potential in treating serious conditions for which available treatments fall short. It is meant to expedite clinical development, regulatory review, and entry into the market upon approval. “While existing immunosuppressive therapies have improved five-year survival for lupus nephritis patients, more than half don’t have an adequate response to treatment, and many progress to end-stage [kidney] disease requiring dialysis or transplant,” Kenneth Kalunian, MD, the lead principal investigator of the ongoing EQUALISE Phase 1b study (NCT04128579) of itolizumab, said in a press release. “There are no FDA approved therapies for lupus nephritis; however, the evaluation of itolizumab provides optimism that we may alleviate this significant unmet medical need for lupus nephritis patients,” he added. Equillium’s itolizumab (EQ001) is a monoclonal antibody that selectively targets the CD6 receptor on the surface of immune T-cells. While T-cells are essential to fight infections and cancer, when abnormally activated, they can lead to inflammatory and autoimmune diseases, such as SLE. The experimental treatment works by blocking the binding between CD6 and one of its ligands — ALCAM — which is found at higher levels in the urine of people with active lupus nephritis. By suppressing their interaction, itolizumab is thought to prevent immune responses mediated by T-cells, reduce kidney inflammation, and prevent further damage. Preclinical data presented last month at the 2019 American College of Rheumatology and the Association of Rheumatology Professionals Annual Meeting supported the treatment’s potential. In mouse models of SLE and lupus nephritis, itolizumab was found to ease kidney disease, while also decreasing the migration of T-cells to inflamed sites and increasing levels of interleukin (IL)-10, an anti-inflammatory molecule. Data also showed that, compared to healthy controls, the number of CD6- and ALCAM-positive cells were increased in kidneys of people with lupus nephritis and were associated with disease activity. Urinary levels of ALCAM were significantly higher in active lupus nephritis — showing potential to be used to discriminate the active disease from inactive SLE or active SLE without lupus nephritis. According to the company, itolizumab also suppressed T-cell development and proliferation, as well as inflammatory responses and molecules such as interferon-gamma, TNF-alpha, IL-6, and IL-17. “Receiving Fast Track designation recognizes the promising therapeutic potential of itolizumab for the treatment for lupus nephritis, particularly given its ability to modulate both the activity and trafficking of effector T cells,” said Krishna Polu, MD, Equillium’s chief medical officer. The EQUALISE study, initiated in September 2019, is evaluating itolizumab’s safety, pharmacokinetics (uptake, distribution, and elimination in the body), pharmacodynamics (the therapy’s effects on the body), and early effectiveness in up to 56 SLE patients with and without active lupus nephritis. EQUALISE includes two groups of participants and treatment regimens. Type A consists of SLE patients to be treated with itolizumab for four weeks, while type B comprises people with active lupus nephritis randomly assigned to receive either itolizumab or a placebo for 12 weeks. Both itolizumab or a placebo will be given subcutaneously (under the skin) every two weeks. Importantly, the EQUALISE trial is also measuring the levels of urinary biomarkers, including ALCAM and CD6, to assess their potential to predict disease progression and treatment response. “y monitoring levels of the CD6-ALCAM pathway in the urine in the EQUALISE trial we will be assessing the opportunity to take a personalized medicine approach to identify patients where the CD6-ALCAM pathway may be a dominant driver of the disease,” Polu said. Marta Figueiredo Marta Figueiredo holds a BSc in Biology and a MSc in Evolutionary and Developmental Biology from the University of Lisbon, Portugal. She is currently finishing her PhD in Biomedical Sciences at the University of Lisbon, where she focused her research on the role of several signalling pathways in thymus and parathyroid glands embryonic development. Fact Checked By: Jose Marques Lopes, PhD José is a science news writer with a PhD in Neuroscience from Universidade of Porto, in Portugal. He has also studied Biochemistry at Universidade do Porto and was a postdoctoral associate at Weill Cornell Medicine, in New York, and at The University of Western Ontario in London, Ontario, Canada. His work has ranged from the association of central cardiovascular and pain control to the neurobiological basis of hypertension, and the molecular pathways driving Alzheimer’s disease. https://lupusnewstoday.com/2019/12/18/itolizumab-granted-fda-fast-track-designation-as-lupus-nephritis-treatment/?utm_source=LUP+NEws+E-mail+List&utm_campaign=e9b1eeb097-RSS_WEEKLY_EMAIL_CAMPAIGN_US&utm_medium=email&utm_term=0_50dac6e56f-e9b1eeb097-71887989
  9. Fatigue has a major impact on quality of life in people with systemic lupus erythematosus, and measuring it using a patient-reported tool may prove useful in clinical trials, new research shows. The findings were presented at the recent 2019 American College of Rheumatology/Association for Rheumatology Professionals Annual Meeting in a session, titled “Assessment of Fatigue in Adults with Moderate to Severe Systemic Lupus Erythematosus (SLE): A Qualitative Study to Explore What Patients Feel Should Be Measured in Clinical Trials.” Fatigue has a well-known impact on people with SLE, but it has not been measured using self-reported feedback from patients, which poses a challenge for assessing the symptom in clinical studies. To address this gap, a team at Evidera, Idorsia Pharmaceuticals, Stanford University, and the Lupus Foundation of America studied how people with SLE view their fatigue and whether it could be assessed with the FACIT-F (Functional Assessment of Chronic Illness Therapy-Fatigue) questionnaire, which has been used in medical research. The study involved 28 adults with moderate to severe SLE (27 women, mean age of 45.5 years). The researchers first conducted focus groups, then 13 one-on-one interviews. Both rounds focused on the role of SLE-related fatigue in participants’ daily lives and their opinions on FACIT-F. Twenty-three patients (82%) had moderate disease activity and five (18%) had severe SLE. All were being treated for SLE during the study. Results showed that 23 participants (82%) identified fatigue as one of the top three most impactful symptoms of SLE. They said that fatigue had a profound impact on daily life, “including the ability to perform chores, work-related activities, maintain personal hygiene, exercise, and participate in hobbies,” the researchers wrote. FACIT-F was generally viewed as a satisfactory tool by the participants, who said that they were able to understand the questionnaire, and it was relevant to their experience of fatigue. Overall, the study confirmed the significant impact of fatigue in the life of people with SLE and showed that it can be measured using FACIT-F. The tool is being used by Idorsia in its CARE Phase 2b clinical trial (NCT03742037) of the potential oral therapy cenerimod. This international study is still enrolling adults with SLE; more information about contacts and locations is available here. Marisa Wexler, MS Marisa holds an MS in Cellular and Molecular Pathology from the University of Pittsburgh, where she studied novel genetic drivers of ovarian cancer. She specializes in cancer biology, immunology, and genetics. Marisa began working with BioNews in 2018, and has written about science and health for SelfHacked and the Genetics Society of America. She also writes/composes musicals and coaches the University of Pittsburgh fencing club. Fact Checked By: Jose Marques Lopes, PhD José is a science news writer with a PhD in Neuroscience from Universidade of Porto, in Portugal. He has also studied Biochemistry at Universidade do Porto and was a postdoctoral associate at Weill Cornell Medicine, in New York, and at The University of Western Ontario in London, Ontario, Canada. His work has ranged from the association of central cardiovascular and pain control to the neurobiological basis of hypertension, and the molecular pathways driving Alzheimer’s disease. Source: https://lupusnewstoday.com/2019/12/13/study-supports-patient-reported-tool-measuring-fatigue-impact-daily-activities/?utm_source=LUP+NEws+E-mail+List&utm_campaign=e9b1eeb097-RSS_WEEKLY_EMAIL_CAMPAIGN_US&utm_medium=email&utm_term=0_50dac6e56f-e9b1eeb097-71887989
  10. January 7, 2020 2019 was a phenomenal, breakthrough year for lupus research on both the clinical development and basic science fronts. The Lupus Research Alliance (LRA) is incredibly proud that every new discovery leading to a brand new medicine for lupus had its origin in work funded by LRA years ago. The past 12 months delivered many exciting “firsts” for lupus — three positive Phase III clinical trials, Fast Track and Breakthrough Therapy designations from the U.S. Food and Drug Administration including one in lupus nephritis (a serious form of lupus affecting the kidneys), and the first treatment approved for pediatric lupus, among other developments. Watch this video to hear the highlights from LRA President & CEO Kenneth Farber while Chief Scientific Officer Dr. Teodora Staeva describes major break throughs in basic research science supported by the LRA. 2019 Was a Year of Many “Firsts” in Lupus Drug Development First Positive Phase 3 Lupus Results in 8 Years — Phase 3 TULIP-2 trial demonstrated the effectiveness of Astra Zeneca’s treatment anifrolumab in reducing lupus disease activity. The LRA has supported numerous studies identifying and unraveling the type I interferon pathway that anifrolumab targets. First Positive Phase 3 Data in Lupus Nephritis — Lupus nephritis, which affects the kidneys, is one of the most dangerous forms of lupus. A late stage trial (AURORA) conducted by Aurinia affirmed the safety and effectiveness of voclosporin. If approved by the FDA, this would be the first medicine specifically approved for this form of lupus. Because of the great need for a new treatment, the company received Fast Track designation from the U.S. FDA. First and Only Lupus Treatment Approved for Use in Children — Benlysta (belimumab) was approved by the U.S. FDA to treat children with lupus who are five years old or above. Pediatric lupus typically hits children harder than adults and comes with extra health issues since children are affected by the disease longer, impacting organ damage. First Breakthrough Therapy Designation for Gazyva Phase 2 Trials Show Effective in Treating Proliferative Lupus Nephritis, the Most Severe Form of Lupus Nephritis – The Phase 2 NOBILITY trial, conducted by Genentech, demonstrated the effectiveness of Gazyva® (obinutuzumab) in combination with mycophenyolate mofetil in treating proliferative lupus nephritis, the most severe form of lupus nephritis that affects the kidneys. The FDA recently granted obinutuzumab Breakthrough Therapy Designation which aims to speed up the development and review of drugs which may demonstrate substantial improvement over available therapy. First Promising, Phase 2 Trial Demonstrates Effectiveness of a Second Interferon Inhibitor — Positive Phase 2 trial results for Biogen’s type I interferon inhibitor BIIB059 demonstrated that it met clinical endpoints in patients with cutaneous lupus (skin related lupus) as well as in systemic lupus. Second Potential Lupus Nephritis Drug Fast Tracked by FDA — A new drug in development by Equillium for lupus nephritis, itolizumab, was just granted Fast Track Designation by the U.S. FDA. The LRA was involved in the design of the clinical trial through its affiliate Lupus Therapeutics and enlisted its patient advisory board to provide the patient perspective on clinical trial education materials. 2019 Discoveries that May Advance New Treatments and a Cure Evidence that Diet May Offer a Treatment — Pieces of bacteria that escape from the intestines may trigger lupus and associated disease flares in some patients, according to a new study led by LRA-grantee Dr. Gregg Silverman. These findings may allow disease treatment with probiotics or diets that alter the mix of bacterial species in the intestines. In addition, a study partly funded by an LRA grant to Dr. Martin Kriegel showed how a diet of high fiber may suppress harmful bacteria and enrich good bacteria in the gut microbiome. Novel Research on Biomarkers is Emerging — Novel research on biomarkers or molecules in the urine, skin and blood in lupus could minimize invasive kidney biopsies. This groundbreaking research is emerging from the Accelerating Medicines Partnership, a RA/SLE initiative involving the NIH, FNIH, industry and LRA. New Targets for Drug Development — Researchers partly funded by the LRA have found possible new targets for drugs to treat lupus after discovering that stopping a molecule BRISC from connecting to another molecule SHMT2 can reduce inflammation. Back to the Future with B Cells — Depleting the number of harmful B cells with a novel immunotherapy that employs modified T cells called CAR T cells may offer an effective strategy to treat lupus, according to results of a study led by LRA-grantee Dr. Marko Radic. These findings offer a renewed optimism for the elimination of B cells to provide a therapeutic option in lupus and pave the way for clinical research to test this new approach. Why the Immune System Goes on the Attack — A new study partly funded by the LRA may help explain how the immune system attacks patients’ DNA in lupus. Together with the laboratory of Dr. David Raulet, Dr. Joshua Woodward and his colleagues discovered a protein door in cells that allows messenger molecules that may promote these attacks to spread. The Lupus Research Alliance is the world’s leading private funder of lupus research, created to improve treatments for lupus while advancing toward a cure. We believe that scientific research is the most powerful way we can improve the lives of people living with lupus, today and over the long term. By pushing the limits of scientific exploration and shepherding new discoveries into potential treatments, we aim to seize every opportunity that will help ease the burden of people living with this difficult disease. As part of the organization’s commitment to advance lupus research and find effective and safer treatments for people living with lupus, the Lupus Research Alliance established Lupus Therapeutics. As the administrative and fiscal entity of the only Lupus Clinical Investigators Network (LuCIN), Lupus Therapeutics manages the Alliance’s clinical trial programs. LuCIN is comprised of more than 200 clinician-scientists at 57 academic medical centers and more than 20,000 active lupus patients. Supported by the Lupus Research Alliance and Lupus Therapeutics, LuCIN scientists work collaboratively to identify potentially transformative treatments and conduct related clinical trials. The LRA celebrates this year’s achievements and looks forward to continued positive developments in 2020. https://www.lupusresearch.org/lra-celebrates-major-research-breakthroughs-in-2019/
  11. Hua-Zhi Ling, Shu-Zhen Xu, Rui-Xue Leng, Jun Wu, Hai-Feng Pan, Yin-Guang Fan, Bin Wang, Yuan-Rui Xia, Qian Huang, Zong-Wen Shuai ... Show more Author Notes Rheumatology, kez634, https://doi.org/10.1093/rheumatology/kez634 Published: 03 January 2020 Abstract Objective Clinical diagnosis of SLE is currently challenging due to its heterogeneity. Many autoantibodies are associated with SLE and are considered potential diagnostic markers, but systematic screening and validation of such autoantibodies is lacking. This study aimed to systematically discover new autoantibodies that may be good biomarkers for use in SLE diagnosis. Methods Sera from 15 SLE patients and 5 healthy volunteers were analysed using human proteome microarrays to identify candidate SLE-related autoantibodies. The results were validated by screening of sera from 107 SLE patients, 94 healthy volunteers and 60 disease controls using focussed arrays comprised of autoantigens corresponding to the identified candidate antibodies. Logistic regression was used to derive and validate autoantibody panels that can discriminate SLE disease. Extensive ELISA screening of sera from 294 SLE patients and 461 controls was performed to validate one of the newly discovered autoantibodies. Results A total of 31, 11 and 18 autoantibodies were identified to be expressed at significantly higher levels in the SLE group than in the healthy volunteers, disease controls and healthy volunteers plus disease control groups, respectively, with 25, 7 and 13 of these differentially expressed autoantibodies being previously unreported. Diagnostic panels comprising anti-RPLP2, anti-SNRPC and anti-PARP1, and anti-RPLP2, anti-PARP1, anti-MAK16 and anti- RPL7A were selected. Performance of the newly discovered anti-MAK16 autoantibody was confirmed by ELISA. Some associations were seen with clinical characteristics of SLE patients, such as disease activity with the level of anti-PARP1 and rash with the level of anti-RPLP2, anti-MAK16 and anti- RPL7A. Conclusion The combined autoantibody panels identified here show promise for the diagnosis of SLE and for differential diagnosis of other major rheumatic immune diseases. Rheumatology key messages Many differentially expressed autoantibodies were newly identified in SLE patients. Autoantibody panels discovered in this study may be good biomarkers for SLE diagnosis. Some associations exist between the autoantibodies identified in this study and clinical characteristics of SLE patients. kez634.pdf
  12. Turning Points in Research for Systemic Lupus in 2019 December 24, 2019 2019's Top Treatmen Advances in Lupus: 2019 was a significant year for new developments in the treatment of systemic lupus. These include new treatment options for systemic lupus and updated treatment guidelines for established treatments. In this slideshow, we highlight a few of the achievements made throughout the year. https://www.rheumatologynetwork.com/lupus/turning-points-research-systemic-lupus-2019
  13. I'm a Doctor With Chronic Illness. Here Are 12 Things I Wish People Knew. Amy Stenehjem, M.D. February 6, 2017 I’ve written this article to help educate those who want to learn about chronic illness. It is written from my perspective, that of a doctor who treated patients with chronic illness for many years, and who spent five years of my life homebound due to chronic illness. I want to spread awareness so that friends, family, employers, coworkers, and health care professionals can better understand chronic illness. My hope is that an increase in awareness will help strengthen relationships, reduce misunderstandings, and improve support systems for those with chronic illness. About Chronic Illness Chronic illness is a disease, condition, or injury that can last years or a lifetime and is typically not curable, though in some cases it may go into remission. It can vary in its severity, with some people able to work and live active or seemingly “normal” lives; while others are very sick and may even be homebound. Many people with chronic illness have an invisible chronic illness. The severity of their symptoms is not clearly noticeable, which may lead to a lack of understanding and support from doctors, family, friends, and coworkers. 1. Nobody wants to feel sick. In all my years as a doctor treating patients with chronic illness, I never saw a patient who enjoyed feeling ill. I saw the opposite, patients who were once very active, desperately trying to find answers and treatment for their overwhelming symptoms. 2. Many doctors don’t understand chronic illness. For years, doctors were under the misperception that some chronic illnesses were caused by depression or anxiety and the only treatment available for these patients was psychiatric care. Despite medical evidence disproving this perception, some doctors are “set in their ways” and do not truly understand chronic illness or how to appropriately address it. Therefore, patients often have to spend precious time searching for a doctor who understands their illness and provides appropriate treatment options while their symptoms potentially worsen. 3. Being unable to work is not a vacation. Those who are not able to work due to chronic illness are not “on vacation.” They are instead, struggling every day to do simple tasks: getting out of bed, getting dressed, making a meal, bathing, etc. They are often homebound, too sick to leave their homes except for doctor appointments. Have you ever been stuck indoors for a couple of days due to bad weather or a temporary health issue? Remember feeling annoyed with the inability to leave your home and be active? Now imagine not being able to leave your home for weeks or months at a time. Frustrating, right? 4. Chronic illness can trigger many emotions. Chronic illness itself can change the biochemical makeup of the mood control center in the brain. In addition, frustrations such as the following can affect a person’s mood and lead to depression and/or anxiety: the wait/search for a diagnosis inability to work and feel productive change in family dynamics loss of social interactions and isolation financial stress the struggle to deal with symptoms and perform simple daily tasks Those with chronic illness often feel a great loss. It is not unusual to experience some or all of the stages of grief (i.e. denial, anger, bargaining, depression, acceptance). They grieve for the life they once lived. They grieve for the life they must endure now. They grieve for the life they dreamed of having. Many people with chronic illness also feel very isolated. Even though they crave social interactions, their symptoms may make it very difficult and at times impossible to talk on the phone or type an email or Facebook post. 5. The symptoms of chronic illness are very complex. The symptoms experienced by those with chronic illness vary depending on the illness; however, many people experience some or all of the following symptoms: extreme fatigue, pain, headaches, brain fog, nausea, and/or dizziness. It is not unusual for the symptoms of chronic illness to wax and wane over time (sometimes even from hour to hour), so planning activities ahead of time can be very difficult. A “good day” for those with chronic illness would likely be considered a sick day for most others. 6. Chronic illness fatigue is much more than being tired. Fatigue is a common symptom in chronic illness and in many cases it is severe, often debilitating. It can be easily triggered by simple daily activities or by more elaborate events such as holidays. Those with chronic illness will often have to “pay the price” for engaging in an activity and then require days, weeks, or even months of recovery. Those with chronic illness may need to rest often and may have to cancel events last minute. This does not mean they are lazy or trying to avoid activities. Once fatigue kicks in, there is no other option other than to rest. It’s as if the body “hits a wall” and can’t go further, no matter what. To better understand the fatigue and limited energy of a person with chronic illness, read this helpful article about the spoon theory. Have you ever been stuck in bed for a few days from a really bad infection, surgery, or hospitalization? Think back to how that felt. You could barely get out of bed and simple tasks were exhausting. Now consider feeling that way every day, all day, for months or years? 7. Pain is a common symptom in those with chronic illness. Those with chronic illness often experience severe pain, including headaches, joint pain, muscle pain, nerve pain, back pain, and/or neck pain. 8. Brain fog is extremely frustrating. Brain fog is frustrating because it is a difficult symptom to describe so that others understand its impact. Brain fog is a cognitive dysfunction common in chronic illness, which can include issues with word finding, concentration, and recall. Those with brain fog often know what they want to say, but can’t find the thoughts or words to communicate effectively. 9. There is a greater risk of dangerous infections. The immune system in those with chronic illness may be overactive and instead of attacking infections the chronic illness immune system wastes time and energy fighting the body’s own organs, joints, nerves, and/or muscles. Many people with chronic illness are on medicines to suppress their overactive immune systems and consequently, need to avoid being around sick people. A minor cold in a healthy person could progress to a dangerous infection in someone with chronic illness. 10. Certain foods can aggravate symptoms. Certain foods may aggravate the symptoms of those with chronic illness. Common culprits are gluten, dairy, sugar, soy, yeast, alcohol, and processed foods. These trigger foods increase inflammation which can cause a significant increase in symptoms which may last for hours or days (sometimes weeks). Because so many of these trigger foods are in our diet, it is often difficult to pinpoint which foods aggravate symptoms and staying away from favorite foods can be a challenge. 11. Sensitivity to smells is common. Certain smells including perfumes, colognes, cleaning agents, and smoke can trigger headaches, brain fog, nausea, and other symptoms in those with chronic illness. Also, some of the medicines used to treat chronic illnesses are low-dose versions of chemotherapy drugs. The sensitivity is similar to that seen in those who are pregnant or on chemotherapy and have a sensitivity to smells. 12. It takes a lot of effort to manage chronic illness. Those with chronic illness have to be very regimented to make sure they get adequate rest, avoid trigger foods, take medications at the correct times, and avoid flares. It is understandable that sometimes they just want to feel “normal” and eat some pizza or stay up late, even if they know they will “pay for it later.” *** Despite struggling with grief, isolation, and often debilitating symptoms, those with chronic illness (and their caregivers) warrior on. They fight daily to be able to understand their bodies and to do things others take for granted. They are often surrounded by a society that does not understand their challenges, and therefore, is unable to provide adequate support. You can make a big difference in the lives of those with chronic illness by learning more about their symptoms and approaching them with compassion and support. Gaining an understanding of chronic illness will help make these conditions less “invisible.” This is why it is so important you are taking the time to read this article. Thank you! This story was originally published on Mastering Health & Happiness. We want to hear your story. Become a Mighty contributor here. Lead photo by Thinkstock Images Amy Stenehjem, M.D. • Follow Dr. Stenehjem works as a Health Consultant using her unique perspective of being a physician who was previously home-bound due to illness. She uses this insight to help her clients, from all over the United States, navigate their symptoms, diagnoses, and healthcare systems to find the answers they need to transform their health. Dr. Stenehjem works with clients experiencing any level of illness, from those just starting to notice a minor change in their health, to those who are home-bound. You can learn more about her work by visiting her website: masteringhealthhappiness.com amy-stenehjem-m-d https://themighty.com/2017/02/doctor-with-chronic-illness-things-to-know/
  14. Omega-3 Fatty Acids For the New Year! Posted by Kathleen Hoffman on Dec 27, 2019 Sav I’ve been eating a load of holiday foods and thinking that I’m going to need to make some dietary adjustments. Like me, you may have read or heard in the news that clinical trials looking at omega-3 fatty acids (omega-3 acid ethyl esters – O3AEE) did NOT significantly reduce major cardiovascular events. In fact, the news may have said that two recent clinical trials had failed. Sometimes, the news media doesn’t take a close enough look at research results! An article reviewing a couple of recent clinical trial results points out that the news media might have got it wrong. The VITAL Clinical Trial The first clinical trial that was reviewed, called VITAL, for Vitamin D and Omega-3 Trial, compared four groups of people (totaling 25,000 participants). The first group took one gram of O3AEE per day, the second group took 2000 IU of vitamin D3 per day, the third group took both O3AEE and Vitamin D3 per day and the fourth group took placebos for five years. When there was a comparison of the four groups after five years, there was no difference overall (that is composite) incidence of cancers or major cardiovascular events. BUT, and this is a major BUT, these are not the only results. There were actually a number of significant results: “28% reduced risk for heart attacks, 50% reduced risk for fatal heart attacks, and 17% reduced risk for total coronary heart disease events,” 1 according to the review. In addition, people who didn’t eat fish or whose fish intake was low (less than 1.5 servings per week) had a significant 19% reduction in overall incidence of major cardiovascular events. Moreover, “For African Americans, there was a significant 77% reduction in heart attacks in the O3AEE group, a 49% reduction in the need for coronary revascularization, and a 53% reduction in total coronary heart disease.”1 The ASCEND Clinical Trial A second study, conducted in the UK, looked at over 15,000 people who had diabetes and no cardiovascular disease diagnosis. Half took the same dosage of O3AEE and the other half (placebo) took a capsule containing olive oil. The news media again just reported the overall endpoint, which was not significant for “a composite of risk for nonfatal MI, nonfatal stroke, transient ischemic attacks, and “vascular death” (including fatal CHD, fatal stroke, and death from other “vascular” causes, in other words, CVD death).” Yet they failed to report one important finding: cardiovascular disease death was reduced by 19%.1 Low Intake of Omega-3 Fatty Acids Image by cattalin from Pixabay Unfortunately, intake of omega-3 fatty acids is low in the US, Australia, Canada and much of the European Union. Omega-3 fatty acids are found in oily fish like salmon, herring, anchovies, sardines, and rainbow trout. The authors of this review recommend that people eat at “least one to two fish/seafood servings per week, which is consistent with current dietary guidelines. Following this recommendation would improve omega-3 intake and status in most individuals…”1 However, a final clinical trial discussed in this review article seemed to support doing more than just trying to eat oily fish. The REDUCE-IT Clinical Trial A different version of omega-3 “icosapent ethyl (IPE; brand name Vascepa”) was used in this clinical trial. This study compared over 8000 people, half who were taking statins while the other half took statins with omega-3 (IPE version). In this study, the omega-3 fatty acid dosage was upped to 4 grams per day. The results were powerful: people taking both the omega-3 fatty acid and the statin had significantly fewer (by 25%) cardiovascular events, than those taking the statins alone. In addition to this overall response, the study also found significant reductions in: “CV death, heart attack, or stroke in the secondary prevention population: 28% (P < .001) CV death or nonfatal heart attack: 26% (P < .001) Fatal or nonfatal heart attack: 31% (P < .001) Urgent or emergent revascularization: 35% (P < .001) CV death: 20% (P < .03) Hospitalization or unstable angina: 32% (P < .002) Fatal or nonfatal stroke: 28% (P < .01) Total mortality, nonfatal heart attack, or nonfatal stroke: 23% (P < .001)”1 The results of this clinical trial, with a higher dosage of omega-3 fatty acids, are impressive. The authors of the review voiced concern that using only the dietary guideline “would likely not be sufficient to reach an intake of 1 g/d of omega-3 fatty acids, a level that provides significant CV benefit for many patients.”1 New Year’s Resolution So, even though you may have heard in the news that omega-3 fatty acid supplements are not worth it and that fish oil Image by Gerd Altmann from Pixabay supplements don’t work, think again. I have. I haven’t been taking my fish oil supplements. And I haven’t been able to eat that much fish every week. My New Year’s resolution? I’m going back on those fish oil pills. Maybe you would like to join me and increase your intake of omega-3 fatty acids. Consider taking an omega-3 fatty acid supplement for your heart’s sake! Kris-Etherton PM, Richter CK, Bowen KJ, et al. Recent Clinical Trials Shed New Light on the Cardiovascular Benefits of Omega-3 Fatty Acids. Methodist DeBakey Cardiovasc J. 2019;15(3):171-8. Feature Image by Elias Shariff Falla Mardini from Pixabay https://medivizor.com/blog/2019/12/27/omega-3-fatty-acids-benefits/
  15. Uric Acid, Gout and the Heart Posted by Kathleen Hoffman on Dec 16, 2019 S You may think of Henry VIII when you think of gout. Called the disease of kings, many associate it with excess. Gout is actually a common disease. Over three million people in the US diagnosed with gout every year. Gout is a builds up of uric acid in tissues, especially in the joints. Uric acid is a byproduct the digestion of purines, a natural substance found in steak, seafood, alcohol (especially beer) and in drinks sweetened with fructose. Usually the body eliminates uric acid through the kidneys but if the kidneys are overwhelmed or unable to process all the uric acid, it builds up in the body. The first joint of the big toe may be where you first experience the pain, redness and burning of gout. Other joints may become involved. However, a recent case study reported in the Annals of Internal Medicine describes uric acid crystals in the heart muscle of a man with uncontrolled gout. The crystals were found in the cells (cardiomyocytes) of the heart muscle and caused myocarditis, an inflammation of the heart muscle. Myocarditis can cause arrhythmias, fluid retention and can lead to heart failure if it is severe and untreated. Risk factors of gout include diet, obesity and a family history. Men are affected more than women but, after menopause, women and men have the same risk of developing gout. Read about gout, uric acid and kidney stones here. Below we share an infographic from the Cleveland Clinic, “Surprising Facts about Gout.” https://medivizor.com/blog/2019/12/16/uric-acid-gout-heart/
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