An Update on the Management of Childhood-Onset Systemic Lupus Erythematosus

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art_TRINDADE_An_Update_on_the_Management_of_ChildhoodOnset_Systemic_2021.PDF (773.98 KB)
Citações na Scopus
49
Tipo de produção
article
Data de publicação
2021
DOI
Scopus
Web of Science
PubMed
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Título do Volume
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ADIS INT LTD
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Citação
PEDIATRIC DRUGS, v.23, n.4, p.331-347, 2021
Projetos de Pesquisa
Unidades Organizacionais
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Resumo
Childhood-onset systemic lupus erythematosus (cSLE) is a prototype of a multisystemic, inflammatory, heterogeneous autoimmune condition. This disease is characterized by simultaneous or sequential organ and system involvement, with unpredictable flare and high levels of morbidity and mortality. Racial/ethnic background, socioeconomic status, cost of medications, difficulty accessing health care, and poor adherence seem to impact lupus outcomes and treatment response. In this article, the management of cSLE patients is updated. Regarding pathogenesis, a number of potential targets for drugs have been studied. However, most treatments in pediatric patients are off-label drugs with recommendations based on inadequately powered studies, therapeutic consensus guidelines, or case series. Management practices for cSLE patients include evaluations of disease activity and cumulative damage scores, routine non-live vaccinations, physical activity, and addressing mental health issues. Antimalarials and glucocorticoids are still the most common drugs used to treat cSLE, and hydroxychloroquine is recommended for nearly all cSLE patients. Disease-modifying antirheumatic drugs (DMARDs) should be standardized for each patient, based on disease flare and cSLE severity. Mycophenolate mofetil or intravenous cyclophosphamide is suggested as induction therapy for lupus nephritis classes III and IV. Calcineurin inhibitors (cyclosporine, tacrolimus, voclosporin) appear to be another good option for cSLE patients with lupus nephritis. Regarding B-cell-targeting biologic agents, rituximab may be used for refractory lupus nephritis patients in combination with another DMARD, and belimumab was recently approved by the US Food and Drug Administration for cSLE treatment in children aged > 5 years. New therapies targeting CD20, such as atacicept and telitacicept, seem to be promising drugs for SLE patients. Anti-interferon therapies (sifalimumab and anifrolumab) have shown beneficial results in phase II randomized control trials in adult SLE patients, as have some Janus kinase inhibitors, and these could be alternative treatments for pediatric patients with severe interferon-mediated inflammatory disease in the future. In addition, strict control of proteinuria and blood pressure is required in cSLE, especially with angiotensin-converting enzyme inhibitor and angiotensin receptor blocker use.
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URI
https://observatorio.fm.usp.br/handle/OPI/41519
Referências
  1. Al Sawah S, 2015, LUPUS SCI MED, V2, DOI 10.1136/lupus-2014-000066
  2. AlE'ed A, 2014, RHEUMATOL INT, V34, P529, DOI 10.1007/s00296-013-2896-8
  3. Aljaberi N, 2021, ARTHRIT CARE RES, V73, P580, DOI 10.1002/acr.24430
  4. Alperin JM, 2018, FRONT IMMUNOL, V9, DOI 10.3389/fimmu.2018.02496
  5. Alveno RA, 2018, J PEDIAT-BRAZIL, V94, P539, DOI 10.1016/j.jped.2017.07.014
  6. An J, 2017, ANNU REV MED, V68, P317, DOI 10.1146/annurev-med-043015-123453
  7. Anuardo P, 2017, PEDIATR CARDIOL, V38, P234, DOI 10.1007/s00246-016-1504-6
  8. Aringer M, 2019, ANN RHEUM DIS, V78, P1151, DOI 10.1136/annrheumdis-2018-214819
  9. Aydin POA, 2018, LUPUS, V27, P657, DOI 10.1177/0961203317751061
  10. Baqi N, 1996, J AM SOC NEPHROL, V7, P924
  11. Bennett L, 2003, J EXP MED, V197, P711, DOI 10.1084/jem.20021553
  12. Esteves GCX, 2018, MOD RHEUMATOL, V28, P649, DOI 10.1080/14397595.2017.1386836
  13. Yu T, 2017, CLIN PHARMACOKINET, V56, P107, DOI 10.1007/s40262-016-0426-z
  14. Passone CGB, 2020, REV PAUL PEDIATR, V38, DOI 10.1590/1984-0462/2020/38/2018101
  15. Bugni VM, 2012, J PEDIAT-BRAZIL, V88, P483, DOI [10.1590/S0021-75572012000600007, 10.2223/JPED.2227]
  16. Carneiro-Sampaio M, 2015, FRONT IMMUNOL, V6, DOI 10.3389/fimmu.2015.00185
  17. Castro M, 2018, LUPUS, V27, P2215, DOI 10.1177/0961203318809883
  18. Chen LY, 2017, CURR OPIN RHEUMATOL, V29, P423, DOI 10.1097/BOR.0000000000000411
  19. Cinar OK, 2021, LUPUS, V30, P527, DOI 10.1177/0961203320981137
  20. Conde PG, 2018, MOD RHEUMATOL, V28, P156, DOI 10.1080/14397595.2017.1332508
  21. Correll CK, 2020, JAMA DERMATOL, V156, P566, DOI 10.1001/jamadermatol.2019.4984
  22. Lopes SRM, 2017, LUPUS, V26, P996, DOI 10.1177/0961203317690616
  23. Costa-Reis P, 2017, CURR OPIN IMMUNOL, V49, P87, DOI 10.1016/j.coi.2017.10.008
  24. Crow MK, 2019, ANNU REV PATHOL-MECH, V14, P369, DOI 10.1146/annurev-pathol-020117-043952
  25. Crow MK, 2014, J IMMUNOL, V192, P5459, DOI 10.4049/jimmunol.1002795
  26. Dall'Era M, 2015, ARTHRITIS RHEUMATOL, V67, P1305, DOI 10.1002/art.39026
  27. Dantas LO, 2020, LUPUS, V29, P144, DOI 10.1177/0961203319897139
  28. Davis AM, 2018, LUPUS, V27, P1532, DOI 10.1177/0961203318779710
  29. DEAPEN D, 1992, ARTHRITIS RHEUM, V35, P311
  30. Demirkaya E, 2020, J CLIN MED, V9, DOI 10.3390/jcm9030712
  31. Deng JH, 2019, SEMIN ARTHRITIS RHEU, V49, P251, DOI 10.1016/j.semarthrit.2019.03.010
  32. Dominguez D, 2021, J RHEUMATOL, V48, P852, DOI 10.3899/jrheum.200002
  33. Lube GE, 2016, PEDIATR BLOOD CANCER, V63, P1238, DOI 10.1002/pbc.25976
  34. Dye AM, 2018, PEDIATR ANN, V47, pE16, DOI 10.3928/19382359-20171215-01
  35. Enyedy EJ, 2001, ARTHRITIS RHEUM, V44, P1114, DOI 10.1002/1529-0131(200105)44:5<1114::AID-ANR192>3.3.CO;2-2
  36. Fanouriakis A, 2020, ANN RHEUM DIS, V79, P713, DOI [10.1136/annrheumdis-2020-216924, 10.1136/annrheumdis-2020-217804]
  37. Farhat SCL, 2020, AUTOIMMUN REV, V19, DOI 10.1016/j.autrev.2020.102640
  38. Feldman CH, 2015, ARTHRIT CARE RES, V67, P1712, DOI 10.1002/acr.22636
  39. Alves AGF, 2018, CLIN RHEUMATOL, V37, P683, DOI 10.1007/s10067-017-3893-1
  40. Ferreira JCOA, 2016, LUPUS, V25, P754, DOI 10.1177/0961203315627203
  41. Ferreira JCOA, 2018, CLIN RHEUMATOL, V37, P3299, DOI 10.1007/s10067-018-4254-4
  42. Figgett WA, 2019, CLIN TRANSL IMMUNOL, V8, DOI 10.1002/cti2.1093
  43. Fiorot FJ, 2019, CLIN RHEUMATOL, V38, P2857, DOI 10.1007/s10067-019-04631-0
  44. Macedo ACL, 2016, FRONT IMMUNOL, V7, DOI 10.3389/fimmu.2016.00055
  45. Fonseca AR, 2015, RHEUMATOLOGY, V54, P241, DOI 10.1093/rheumatology/keu278
  46. Fonseca AR, 2019, ADV RHEUMATOL, V59, DOI 10.1186/s42358-019-0062-z
  47. Franklyn K, 2016, ANN RHEUM DIS, V75, P1615, DOI 10.1136/annrheumdis-2015-207726
  48. Furie R, 2017, ARTHRITIS RHEUMATOL, V69, P376, DOI 10.1002/art.39962
  49. Goulart MFG, 2020, PEDIATR NEPHROL, V35, P1247, DOI 10.1007/s00467-020-04517-3
  50. Golder V, 2020, RHEUMATOLOGY, V59, P19, DOI 10.1093/rheumatology/keaa420
  51. Golder V, 2019, LANCET RHEUMATOL, V1, pE95, DOI 10.1016/S2665-9913(19)30037-2
  52. Gomes RC, 2016, ARTHRIT CARE RES, V68, P1736, DOI 10.1002/acr.22881
  53. Gordon C, 2018, RHEUMATOLOGY, V57, pE1, DOI 10.1093/rheumatology/kex286
  54. Gormezano NWS, 2017, LUPUS, V26, P426, DOI 10.1177/0961203316676379
  55. Lythgoe H, 2017, LUPUS, V26, P1285, DOI 10.1177/0961203317700484
  56. Gormezano NWS, 2016, SEMIN ARTHRITIS RHEU, V45, P706, DOI 10.1016/j.semarthrit.2015.10.015
  57. Gormezano NWS, 2016, CLIN RHEUMATOL, V35, P227, DOI 10.1007/s10067-015-3127-3
  58. Gormezano NWS, 2015, PEDIATR INFECT DIS J, V34, P905, DOI 10.1097/INF.0000000000000756
  59. Groot N, 2019, ARTHRITIS RHEUMATOL, V71, P290, DOI 10.1002/art.40697
  60. Groot N, 2017, ANN RHEUM DIS, V76, P1965, DOI 10.1136/annrheumdis-2017-211898
  61. Groot N, 2017, ANN RHEUM DIS, V76, P1788, DOI 10.1136/annrheumdis-2016-210960
  62. Groot N, 2015, CURR RHEUMATOL REP, V17, DOI 10.1007/s11926-015-0519-y
  63. Gualano B, 2017, NAT REV RHEUMATOL, V13, P368, DOI 10.1038/nrrheum.2017.75
  64. Guariento A, 2015, REV BRAS REUMATOL, V55, P346, DOI [10.1016/j.rbr.2014.12.010, 10.1016/j.rbre.2014.12.009]
  65. Guiducci C, 2010, NATURE, V465, P937, DOI 10.1038/nature09102
  66. Ma MQ, 2020, ARTHRIT CARE RES, V72, P1597, DOI 10.1002/acr.24057
  67. Gutierrez-Suarez R, 2006, ARTHRITIS RHEUM-US, V54, P2989, DOI 10.1002/art.22048
  68. Harris JG, 2017, CLIN RHEUMATOL, V36, P351, DOI 10.1007/s10067-016-3518-0
  69. Harry O, 2019, LUPUS, V28, P642, DOI 10.1177/0961203319839478
  70. Hartman EAR, 2018, AUTOIMMUN REV, V17, P316, DOI 10.1016/j.autrev.2018.01.007
  71. Hedrich CM, 2017, BEST PRACT RES CL RH, V31, P488, DOI 10.1016/j.berh.2018.02.001
  72. Heshin-Bekenstein M, 2019, SEMIN ARTHRITIS RHEU, V49, P267, DOI 10.1016/j.semarthrit.2019.05.010
  73. Hochberg MC, 1997, ARTHRITIS RHEUM, V40, P1725, DOI 10.1002/art.1780400928
  74. Holland MJ, 2018, ARTHRIT CARE RES, V70, P1621, DOI 10.1002/acr.23531
  75. Hollander MC, 2013, ARTHRIT CARE RES, V65, P1416, DOI 10.1002/acr.21998
  76. Hong SD, 2009, ARTHRITIS RHEUM-US, V60, P3400, DOI 10.1002/art.24902
  77. Machida H, 2010, NEPHROL DIAL TRANSPL, V25, P2530, DOI 10.1093/ndt/gfq058
  78. HOOKS JJ, 1979, NEW ENGL J MED, V301, P5, DOI 10.1056/NEJM197907053010102
  79. Islaba AG, 2020, AUTOIMMUN REV, V19, DOI 10.1016/j.autrev.2020.102693
  80. Jesus AA, 2011, LUPUS, V20, P1275, DOI 10.1177/0961203311411598
  81. Jesus AA, 2009, ANN NY ACAD SCI, V1173, P235, DOI 10.1111/j.1749-6632.2009.04675.x
  82. Jin O, 2008, LUPUS, V17, P654, DOI 10.1177/0961203308089410
  83. Jones JT, 2016, ARTHRIT CARE RES, V68, P73, DOI 10.1002/acr.22650
  84. Jongvilaikasem P, 2021, EUR J PEDIATR, V180, P1431, DOI 10.1007/s00431-020-03910-2
  85. Joo YB, 2016, J RHEUMATOL, V43, P1490, DOI 10.3899/jrheum.151129
  86. Kahwage PP, 2017, CLIN RHEUMATOL, V36, P547, DOI 10.1007/s10067-016-3534-0
  87. Kavanaugh AF, 2002, ARTHRIT RHEUM-ARTHR, V47, P546, DOI 10.1002/art.10558
  88. Mackay M, 2019, ARTHRITIS RHEUMATOL, V71, P411, DOI 10.1002/art.40724
  89. Kelvin AA, 2020, LANCET INFECT DIS, V20, P633, DOI 10.1016/S1473-3099(20)30236-X
  90. Khamashta M, 2016, ANN RHEUM DIS, V75, P1909, DOI 10.1136/annrheumdis-2015-208562
  91. Klumb EM, 2015, REV BRAS REUMATOL, V55, P1, DOI 10.1016/j.rbr.2014.09.008
  92. Knight AM, 2016, J RHEUMATOL, V43, P1136, DOI 10.3899/jrheum.151228
  93. Lattanzi B, 2011, ARTHRIT CARE RES, V63, pS112, DOI 10.1002/acr.20623
  94. Ferriani MPL, 2015, INT ARCH ALLERGY IMM, V167, P186, DOI 10.1159/000438723
  95. Lim LSH, 2017, ARTHRIT CARE RES, V69, P1627, DOI 10.1002/acr.23199
  96. Lim LSH, 2013, J RHEUMATOL, V40, P513, DOI 10.3899/jrheum.121096
  97. Liphaus BL, 2020, ANN RHEUM DIS, V79, P427, DOI 10.1136/annrheumdis-2019-216410
  98. Liphaus BL, 2020, CLIN RHEUMATOL, V39, P509, DOI 10.1007/s10067-019-04799-5
  99. Mahajan A, 2020, LUPUS, V29, P1011, DOI 10.1177/0961203320932219
  100. Liphaus BL, 2015, CLINICS, V70, P220, DOI 10.6061/clinics/2015(03)12
  101. Liu ZH, 2015, ANN INTERN MED, V162, P18, DOI 10.7326/M14-1030
  102. Lo MS, 2018, FRONT IMMUNOL, V9, DOI 10.3389/fimmu.2018.01278
  103. Mak A, 2014, J IMMUNOL RES, V2014, DOI 10.1155/2014/419029
  104. Manson JJ, 2006, ORPHANET J RARE DIS, V1, DOI 10.1186/1750-1172-1-6
  105. Blanco P, 2001, SCIENCE, V294, P1540, DOI 10.1126/science.1064890
  106. Marmor MF, 2016, OPHTHALMOLOGY, V123, P1386, DOI 10.1016/j.ophtha.2016.01.058
  107. Marques VLS, 2016, J PEDIATR GASTR NUTR, V62, P328, DOI 10.1097/MPG.0000000000000990
  108. Massias JS, 2020, LUPUS, V29, P474, DOI 10.1177/0961203320909156
  109. Medhat BM, 2020, CLIN RHEUMATOL, V39, P435, DOI 10.1007/s10067-019-04776-y
  110. Miguel DF, 2020, ADV RHEUMATOL, V60, DOI 10.1186/s42358-020-0114-4
  111. Mina R, 2016, ARTHRIT CARE RES, V68, P179, DOI 10.1002/acr.22666
  112. Silva VBME, 2019, REV PAUL PEDIATR, V37, P149, DOI 10.1590/1984-0462/;2019;37;2;00015
  113. Mok CC, 2017, BEST PRACT RES CL RH, V31, P429, DOI 10.1016/j.berh.2017.09.010
  114. Mok CC, 2016, ANN RHEUM DIS, V75, P30, DOI 10.1136/annrheumdis-2014-206456
  115. Neely J, 2018, CURR OPIN RHEUMATOL, V30, P498, DOI 10.1097/BOR.0000000000000523
  116. Blay G, 2018, ADV RHEUMATOL, V58, DOI 10.1186/s42358-018-0038-4
  117. Novak GV, 2018, LUPUS, V27, P1712, DOI 10.1177/0961203318787037
  118. Novak GV, 2017, AUTOIMMUN REV, V16, P132, DOI 10.1016/j.autrev.2016.12.004
  119. Obermoser G, 2010, LUPUS, V19, P1012, DOI 10.1177/0961203310371161
  120. Oliveira-Santos M, 2011, LUPUS, V20, P320, DOI 10.1177/0961203310383736
  121. Palmer SC, 2017, AM J KIDNEY DIS, V70, P324, DOI 10.1053/j.ajkd.2016.12.008
  122. Parodis I, 2020, LUPUS SCI MED, V7, DOI 10.1136/lupus-2020-000389
  123. Peterknecht E, 2018, LUPUS, V27, P2135, DOI 10.1177/0961203318804879
  124. Petri M, 2012, ARTHRITIS RHEUM-US, V64, P2677, DOI 10.1002/art.34473
  125. Pin A, 2020, INT J MOL SCI, V21, DOI 10.3390/ijms21207767
  126. Pinto AJ, 2016, ARTHRIT CARE RES, V68, P1780, DOI 10.1002/acr.22905
  127. Bousfiha A, 2020, J CLIN IMMUNOL, V40, P66, DOI 10.1007/s10875-020-00758-x
  128. Pons-Estel BA, 2018, ANN RHEUM DIS, V77, P1549, DOI 10.1136/annrheumdis-2018-213512
  129. Pons-Estel GJ, 2017, EXPERT REV CLIN IMMU, V13, P799, DOI 10.1080/1744666X.2017.1327352
  130. Ponticelli C, 2017, EXPERT OPIN DRUG SAF, V16, P411, DOI 10.1080/14740338.2017.1269168
  131. Postal M, 2012, CLINICS, V67, P157, DOI 10.6061/clinics/2012(02)11
  132. Putera AM, 2020, NEUROPSYCH DIS TREAT, V16, P1583, DOI 10.2147/NDT.S250373
  133. Ramos GF, 2019, J PEDIAT-BRAZIL, V95, P667, DOI 10.1016/j.jped.2018.06.006
  134. Rivas-Larrauri F, 2016, REUMATOL CLIN, V12, P274, DOI 10.1016/j.reuma.2016.01.005
  135. Rodriguez-Smith J, 2019, CURR OPIN RHEUMATOL, V31, P464, DOI 10.1097/BOR.0000000000000621
  136. Rodsaward Pongsawat, 2019, Asian Pac J Allergy Immunol, DOI 10.12932/AP-211218-0465
  137. Ronnblom L, 2003, ARTHRITIS RES THER, V5, P68, DOI 10.1186/ar625
  138. Brunner HI, 2020, ANN RHEUM DIS, V79, P1340, DOI 10.1136/annrheumdis-2020-217101
  139. Grein IHR, 2020, LUPUS, V29, P934, DOI 10.1177/0961203320928406
  140. Rovin BH, 2019, KIDNEY INT, V95, P219, DOI 10.1016/j.kint.2018.08.025
  141. Rubin HR, 2001, INT J QUAL HEALTH C, V13, P469, DOI 10.1093/intqhc/13.6.469
  142. Rubinstein TB, 2018, ARTHRIT CARE RES, V70, P420, DOI 10.1002/acr.23285
  143. Rygg M, 2012, ANN RHEUM DIS, V71, P511, DOI 10.1136/annrheumdis-2011-200106
  144. Saferding V, 2020, J AUTOIMMUN, V110, DOI 10.1016/j.jaut.2019.102382
  145. Sag E, 2014, CLIN EXP RHEUMATOL, V32, P440
  146. Sakamoto AP, 2017, ACTA REUMATOL PORT, V42, P250
  147. Sakamoto AP, 2017, REV BRAS REUMATOL, V57, P583, DOI 10.1016/j.rbre.2017.09.002
  148. Sakamoto AP, 2016, RHEUMATOL INT, V36, P1641, DOI 10.1007/s00296-016-3564-6
  149. Brunner HI, 2019, ARTHRIT CARE RES, V71, P579, DOI 10.1002/acr.23834
  150. Sakata K, 2018, FRONT IMMUNOL, V9, DOI 10.3389/fimmu.2018.01957
  151. Salah S, 2011, PEDIATR RHEUMATOL, V9, DOI 10.1186/1546-0096-9-36
  152. Scalzi LV, 2018, PEDIATR RHEUMATOL, V16, DOI 10.1186/s12969-018-0232-2
  153. Schulze-Koops H, 2021, RMD OPEN, V7, DOI 10.1136/rmdopen-2020-001553
  154. Setoue DN, 2018, AUTOIMMUN REV, V17, P836, DOI 10.1016/j.autrev.2018.03.009
  155. Shah K, 2021, BIOLOGICALS, V69, P1, DOI 10.1016/j.biologicals.2020.11.002
  156. Silva CA, 2013, NAT REV RHEUMATOL, V9, P532, DOI 10.1038/nrrheum.2013.95
  157. Silva CA, 2019, REV PAUL PEDIATR, V37, P138, DOI 10.1590/1984-0462/;2019;37;2;00019
  158. Silva CA, 2016, EXPERT REV CLIN IMMU, V12, P907, DOI 10.1080/1744666X.2016.1195685
  159. Silva CA, 2016, EXPERT REV CLIN IMMU, V12, P301, DOI 10.1586/1744666X.2016.1123621
  160. Brunner HI, 2019, ANN RHEUM DIS, V78, P162, DOI 10.1136/annrheumdis-2018-213198
  161. Silva MF, 2015, J RHEUMATOL, V42, P2296, DOI 10.3899/jrheum.150142
  162. Singla S, 2017, FRONT PEDIATR, V5, DOI 10.3389/fped.2017.00104
  163. Smith EMD, 2019, CLIN IMMUNOL, V209, DOI 10.1016/j.clim.2019.108274
  164. Speth F, 2018, LUPUS, V27, P1996, DOI 10.1177/0961203318783057
  165. Tamirou F, 2015, LUPUS SCI MED, V2, DOI 10.1136/lupus-2015-000123
  166. Tang W, 2021, LUPUS SCI MED, V8, DOI 10.1136/lupus-2021-000479
  167. Tao JJ, 2019, J RHEUMATOL, V46, P731, DOI 10.3899/jrheum.180337
  168. Thorbinson C, 2016, PEDIATR DRUGS, V18, P181, DOI 10.1007/s40272-016-0170-8
  169. Tiseo BC, 2016, INT BRAZ J UROL, V42, P11, DOI 10.1590/S1677-5538.IBJU.2014.0595
  170. Tocut M, 2020, EXPERT OPIN INV DRUG, V29, P1151, DOI 10.1080/13543784.2020.1807004
  171. Brunner HI, 2019, PEDIATR NEPHROL, V34, P117, DOI 10.1007/s00467-018-4049-5
  172. Tsokos GC, 2016, NAT REV RHEUMATOL, V12, P716, DOI 10.1038/nrrheum.2016.186
  173. Tunnicliffe DJ, 2016, ARTHRIT CARE RES, V68, P828, DOI 10.1002/acr.22749
  174. Ugolini-Lopes MR, 2017, LUPUS SCI MED, V4, DOI 10.1136/lupus-2017-000213
  175. van Weelden M, 2016, REV BRAS REUMATOL, V56, P228, DOI 10.1016/j.rbre.2016.02.001
  176. Wahadat MJ, 2018, ARTHRITIS RES THER, V20, DOI 10.1186/s13075-017-1501-z
  177. Wallace M, 2021, MMWR-MORBID MORTAL W, V70, P749, DOI 10.15585/mmwr.mm7020e1
  178. Wang E, 2020, J ALLER CL IMM-PRACT, V8, P2118, DOI 10.1016/j.jaip.2020.04.024
  179. Watson L, 2014, PEDIATR NEPHROL, V29, P397, DOI 10.1007/s00467-013-2668-4
  180. Watson L, 2012, ARTHRITIS RHEUM-US, V64, P2356, DOI 10.1002/art.34410
  181. Webber D, 2020, RHEUMATOLOGY, V59, P90, DOI 10.1093/rheumatology/kez220
  182. Brunner HI, 2018, ARTHRIT CARE RES, V70, P813, DOI 10.1002/acr.23557
  183. Wenderfer SE, 2017, PEDIATR RES, V81, P406, DOI 10.1038/pr.2016.247

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