Researchers Find a Link Between Some Lupus Erythematosus Cases and Drug Exposure

According to a September 2 study which JAMA Dermatology published online, Certain occurrences of subacute "cutaneous lupus erythematosus or CLE and systemic lupus erythematosus or SLE are both drug-induced.

Specifically, Denmark-based Herlev and Gentofte University Hospital's Jeanette Halskou Haugaard, MD, and colleagues investigated the link between the use of drugs and a subsequent diagnosis of either CLE or SLE.

As indicated in several reports, the "Danish National Patient Register" from 2000 to 2017 was used to determine more than 1,200 patients who had SLE, and more than 31,400 age- and sex-matched controls.

The study authors observed a lot of considerable links between the use of drug and succeeding diagnosis of CLE and SLE with many of such links, perhaps, because of protopathic bias.

Nonetheless, new probable causal links were identified for CLE or SLE, and exposure to drugs such as "fexofenadine hydrochloride, levothyroxine sodium, metoclopramide hydrochloride, and metronidazole chloride."

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Drug-Induced Lupus

Also called DIL, drug-induced lupus is among the most extensively described drug-induced rheumatologic syndromes.

It has been approximated that a maximum of 10-percent SLE cases is drug-induced, which estimates to 15,000 to 30,000 cases each year.

The first drug to be implied in lupus's causation in 1945 was identified as "sulfadiazine." According to past research, a particular connection between lupus and hydralazine was originally "described in 1953."

To meet the standard for a drug-induced syndrome, an individual needs to be exposed to the offending agent, as well as the clinical and laboratory evidence for a particular rheumatologic syndrome minus previous evidence of such a syndrome, and speedy improvement of both symptoms and serologic results upon stopping use of the drug.

DIL is a syndrome similar to a milder variation idiopathic SLE and presents following exposure to an offending drug.

Usually, patients with DIL experience occurrences, particularly like arthritis, myalgia, serositis, and arthralgia.

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Forms of DIL

Studies show that a lot of drugs presently available "are capable inducing autoantibodies" which can result in a drug-induced condition like DIL.

Consequently, at least 80 kinds of drugs have been determined and can lead to DIL. The specific standard for diagnosing DIL has not been defined although researchers have made recommendations to aid such a diagnosis.

Previous research indicates, there are three forms of drug-induced lupus presently recognized. These are the "system DIL, the drug-induced CCLE, and drug-induced SCLE

In connection with drug-induced SCLE, studies specify, it can be triggered by medicines like "terbinafine, hydrochlorothiazide, etanercept, and calcium channel blockers."

Essentially, new drugs are progressively entering the market with a tool of action that alters the immunologic reaction in a patient.

Specifically for pharmacists, the consciousness of the probable adverse effects of such medicines can help identify the drug-induced syndrome in patients.

In such an occurrence, patients need to be counseled so they'd know the signs and symptoms of DIL, not to mention, encouraged to report any concerns to their doctor.

The new research findings propose the study authors said, that doctors need to be aware too if a new CE or SLE case could possibly be drug-induced.

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