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  1. Article ; Online: Severe thrombocytopenia is associated with high mortality in systemic lupus erythematosus-analysis from Indian SLE Inception cohort for Research (INSPIRE).

    Shobha, Vineeta / Rajasekhar, Liza / Bhat, Vasudha / Mathew, Ashish J / Kavadichanda, Chengappa / Rathi, Manish / Gupta, Ranjan / Selvam, Sumithra / Aggarwal, Amita

    Clinical rheumatology

    2023  Volume 42, Issue 9, Page(s) 2279–2285

    Abstract: Thrombocytopenia in patients with systemic lupus erythematosus (SLE) is associated with higher morbidity and mortality. We report frequency, associations and short-term outcome of moderate-severe thrombocytopenia in a prospective inception cohort from ... ...

    Abstract Thrombocytopenia in patients with systemic lupus erythematosus (SLE) is associated with higher morbidity and mortality. We report frequency, associations and short-term outcome of moderate-severe thrombocytopenia in a prospective inception cohort from India (INSPIRE). We evaluated consecutive SLE patients classified per SLICC2012 for the occurrence of thrombocytopenia and its associations. The outcomes assessed included bleeding manifestations, kinetics of thrombocytopenia recovery, mortality and recurrence of thrombocytopenia. Among a total of 2210 patients in the cohort, 230 (10.4%) had incident thrombocytopenia, of whom moderate (platelet count [PC] 20-50 × 10
    MeSH term(s) Humans ; Lupus Erythematosus, Systemic ; Prospective Studies ; Symptom Flare Up ; Thrombocytopenia/complications ; Leukopenia/complications ; Antiphospholipid Syndrome/complications ; Lupus Coagulation Inhibitor
    Chemical Substances Lupus Coagulation Inhibitor
    Language English
    Publishing date 2023-06-04
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 604755-5
    ISSN 1434-9949 ; 0770-3198
    ISSN (online) 1434-9949
    ISSN 0770-3198
    DOI 10.1007/s10067-023-06641-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Prevalence and Clinical Correlates of Myositis Specific Autoantibodies in Idiopathic Immune-Mediated Inflammatory Myositis - Results from a Multicentric Cohort (MyoIN) from India.

    Rajasekhar, Liza / Shobha, Vineeta / Narasimhan, Anitha / Bhat, Vasudha / Amin, S N / Misra, Ramnath

    The Journal of the Association of Physicians of India

    2021  Volume 69, Issue 1, Page(s) 36–40

    Abstract: There is a need to understand the clinical and antibody associations in patients with IIM in various ethnicities and geographical areas. Patients who fulfilled Bohan's and Peter criteria of IIM and seen between October 2017 through Jan 2020 were enrolled ...

    Abstract There is a need to understand the clinical and antibody associations in patients with IIM in various ethnicities and geographical areas. Patients who fulfilled Bohan's and Peter criteria of IIM and seen between October 2017 through Jan 2020 were enrolled in this study at 3 centres. Clinical and relevant laboratory parameters were recorded in a pre designed case record form. MSA and MAA to 16 antigens were performed by line blot assay using Euroimmun (Luebec, Germany) as per manufacturer's instruction. Of the 150 patients, 13 were juvenile onset. Ninety sera had either one MSA or MAA. Sixty sera had neither MSA/MAA. anti-Ro 52 were the commonest antibody and anti-Mi-2α and b the commonest MSA. Novel associations identified were severe myositis with anti-Ro 52, cutaneous ulcerations with anti-MDA5 and anti-PM-Scl and calcinosis with anti-PM-Scl. One-third sera had no MSA or MAA. Larger sample size and use of antibody assays together with muscle biopsy will improve subtyping and phenotype associations in IIM.
    MeSH term(s) Autoantibodies ; Germany ; Humans ; India/epidemiology ; Myositis/epidemiology ; Prevalence
    Chemical Substances Autoantibodies
    Language English
    Publishing date 2021-07-09
    Publishing country India
    Document type Journal Article
    ZDB-ID 800766-4
    ISSN 0004-5772
    ISSN 0004-5772
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Long Term Outcomes in Idiopathic Inflammatory Myositis: An Observational Epidemiologic Study over 15 Years.

    Janardana, Ramya / Kn, Sangeetha / Bhat, Vasudha / Balakrishnan, Divya / Raj, John Michael / Pinto, Benzeeta / K, Chanakya / Nadig, Raghunandan / Mahadevan, Anita / Shobha, Vineeta

    Mediterranean journal of rheumatology

    2023  Volume 34, Issue 4, Page(s) 513–524

    Abstract: Background: We report a longitudinal observational cohort of idiopathic inflammatory myositis (IIM) focusing on the long-term clinical outcome and associated parameters.: Methods: IIM patients were classified as per Bohan and Peter criteria. In those ...

    Abstract Background: We report a longitudinal observational cohort of idiopathic inflammatory myositis (IIM) focusing on the long-term clinical outcome and associated parameters.
    Methods: IIM patients were classified as per Bohan and Peter criteria. In those with ≥ 24 months of follow-up; the treatment response, functional outcomes, and damage at last follow-up were recorded. Complete clinical response and clinical remission as defined by Oddis et al., was used to define outcomes at last follow-up.
    Results: The cohort consists of 175 patients, mean age 40.9 (+12.6) years, M:F 1:3.3; and the major subsets were dermatomyositis (44.6%), overlap myositis (25.7%), antisynthetase syndrome (6.3%), polymyositis (14.3%), and juvenile DM/OM (8.6%). Ninety-four patients have followed up for 24 months or more, with the median (IQR) of 65(35,100.7) months. Of them, 74.1% and 11.8% had complete and partial clinical responses respectively at the last follow-up. In our cohort 40.2% were off-steroids and 13.8% were in clinical remission at the last follow-up. Complete clinical response was associated with better functional outcomes and lesser damage as determined by HAQ-DI of 0[OR10.9; 95%CI (3.3,160)], MRS [OR 3.2; 95%CI (1.4,7.3)] and lesser MDI [OR 1.7; 95% CI (1.1,2.7)] respectively as compared to partial response (unadjusted analysis). Baseline parameters and IIM subsets did not significantly influence the functional outcome and damage. The mortality rate in our cohort is 24/175 (13.7%), the disease-specific mortality rate being 9.1%. Large majority of deaths were early, associated with active disease.
    Conclusion: We report good long-term outcomes in all major myositis subsets. Partial clinical response to treatment is associated with worse functional outcomes and damage accrual. Death occurs early in association with active disease.
    Language English
    Publishing date 2023-08-28
    Publishing country Greece
    Document type Journal Article
    ZDB-ID 3019943-8
    ISSN 2529-198X ; 2459-3516
    ISSN (online) 2529-198X
    ISSN 2459-3516
    DOI 10.31138/mjr.280823.lto
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Maternal and fetal outcomes of lupus pregnancies: A collective effort by Karnataka Rheumatologists.

    Janardana, Ramya / Haridas, Vikram / Priya, Vishnu / Bhat, Vasudha / Singh, Yogesh / Rao, Vijay K / Jois, Ramesh / Srikantiah, Chandrashekara / Pinto, Benzeeta / Shobha, Vineeta

    Lupus

    2020  Volume 29, Issue 11, Page(s) 1397–1403

    Abstract: Introduction: Identifying factors predicting adverse pregnancy outcomes involving systemic lupus erythematosus (SLE) is a research priority. The aims of this study were to investigate (a) the maternal and fetal outcomes of pregnant lupus patients and ... ...

    Abstract Introduction: Identifying factors predicting adverse pregnancy outcomes involving systemic lupus erythematosus (SLE) is a research priority. The aims of this study were to investigate (a) the maternal and fetal outcomes of pregnant lupus patients and the factors associated with adverse pregnancy outcomes, and (b) the effect of pregnancy on lupus disease activity of these patients.
    Methods: This was an ambi-directional study collecting information from five multi-specialist referral centres across the state of Karnataka, India over 5 years (2013-2018). Clinical details of pregnancies and outcomes that were temporally associated with lupus disease were recorded using a structured pro forma. The Safety of Estrogen in SLE National Assessment-SLE Disease Activity Index (SELENA-SLEDAI) was used to assess lupus activity during the 6 months prior to pregnancy and the intra- and post-partum periods. Modifications suggested in the SLE Pregnancy Disease Activity Index were considered while scoring.
    Results: A total of 121 pregnancies in 80 SLE patients with a mean age of 27.1 (±4.5) years and with a mean disease duration of 4.6 (±4.1) years were reviewed. Largely patients were in clinical remission (109/121; 90.1%). Antiphospholipid antibody positivity was seen in 45/121 (37.2%) patients. A history of lupus nephritis was noted in 29/121 (24%) patients. Maternal complications (32%) were mainly due to hypertensive disorders of pregnancy (HDP; 19/121; 15.7%). Adverse fetal outcomes (58%) were mainly in the form of spontaneous first-trimester abortions (21/121; 16%), stillbirth (14/121; 11.6%) and prematurity (24/121; 20%). HDP is strongly associated with stillbirth and prematurity and is independent of active lupus. Disease activity was associated with a three-fold increased risk of adverse fetal outcome in univariate analysis. The risk of major flare during pregnancy is low (4.1%) when conception occurs during stable disease. Hydroxychloroquine (HCQ) use was associated with reduced risk of flare (
    Conclusions: The risk of major flare during pregnancy is low when conception happens during stable disease. HCQ use was associated with reduced risk of flare in patients in remission at the time of conception. HDP was strongly associated with stillbirth and prematurity and are independent of active lupus in our cohort.
    MeSH term(s) Abortion, Spontaneous/epidemiology ; Adult ; Female ; Humans ; Hydroxychloroquine/therapeutic use ; India/epidemiology ; Infant, Newborn ; Lupus Erythematosus, Systemic/complications ; Lupus Erythematosus, Systemic/drug therapy ; Lupus Nephritis/complications ; Pre-Eclampsia/diagnosis ; Pre-Eclampsia/etiology ; Pregnancy ; Pregnancy Complications/diagnosis ; Pregnancy Complications/etiology ; Pregnancy Outcome/epidemiology ; Premature Birth/epidemiology ; Remission Induction ; Severity of Illness Index ; Young Adult
    Chemical Substances Hydroxychloroquine (4QWG6N8QKH)
    Language English
    Publishing date 2020-08-02
    Publishing country England
    Document type Journal Article ; Multicenter Study
    ZDB-ID 1154407-7
    ISSN 1477-0962 ; 0961-2033
    ISSN (online) 1477-0962
    ISSN 0961-2033
    DOI 10.1177/0961203320944503
    Database MEDical Literature Analysis and Retrieval System OnLINE

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