Leonid D Zamora, MD - University of Santo Tomas Hospital - Consultant

Leonid D Zamora

MD

University of Santo Tomas Hospital

Consultant

Manila, Metro Manila | Philippines

Main Specialties: Internal Medicine, Rheumatology

Additional Specialties: Rheumatology

ORCID logohttps://orcid.org/0000-0002-4209-4442


Top Author

Leonid D Zamora, MD - University of Santo Tomas Hospital - Consultant

Leonid D Zamora

MD

Introduction

I M a rheumatologist with special interest in autoimmune diseases especially SLE.

Primary Affiliation: University of Santo Tomas Hospital - Manila, Metro Manila , Philippines

Specialties:

Additional Specialties:

Research Interests:


View Leonid D Zamora’s Resume / CV

Education

Apr 2006
University of Santo Tomas
Doctor of Medicine

Publications

10Publications

547Reads

23Profile Views

5PubMed Central Citations

Lupus education for physicians and patients in a resource-limited setting.

Clin Rheumatol 2020 Mar 5;39(3):697-702. Epub 2019 Nov 5.

Section of Pediatric Rheumatology, University of Santo Tomas, Manila, Philippines.

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http://dx.doi.org/10.1007/s10067-019-04795-9DOI Listing
March 2020
1.774 Impact Factor

Risk factors for herpes zoster infection among Filipinos with systemic lupus erythematosus.

Int J Rheum Dis 2020 Feb 6;23(2):197-202. Epub 2019 Nov 6.

Section of Rheumatology, University of Santo Tomas, Manila, Philippines.

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http://dx.doi.org/10.1111/1756-185X.13725DOI Listing
February 2020
1 Read
1.771 Impact Factor

Longitudinal associations of active renal disease with irreversible organ damage accrual in systemic lupus erythematosus.

Lupus 2019 Dec 13;28(14):1669-1677. Epub 2019 Nov 13.

School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia.

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http://dx.doi.org/10.1177/0961203319887799DOI Listing
December 2019
2.197 Impact Factor

Serotonin syndrome masquerading as disease flare in lupus nephritis with end-stage renal disease.

Int J Rheum Dis 2019 Oct 19;22(10):1933-1936. Epub 2019 Aug 19.

Section of Rheumatology, University of Santo Tomas Hospital, Manila, Philippines.

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http://dx.doi.org/10.1111/1756-185X.13683DOI Listing
October 2019
4 Reads
1.771 Impact Factor

Evaluation of remission definitions for systemic lupus erythematosus: a prospective cohort study

Lancet Rheumatology

SummaryValidated outcome measures are needed from which to derive treatment strategies for systemic lupus erythematosus (SLE). However, no definition of remission for SLE has been widely adopted. The Definitions of Remission in Systemic Lupus Erythematosus (DORIS) group has proposed a framework with multiple potential definitions of remission. In this study, we aimed to assess the attainability and effect on disease outcomes of the DORIS definitions of remission, compared with the lupus low disease activity state (LLDAS), in patients with SLE. Methods In this prospective cohort study, we enrolled patients with SLE from 13 international centres that are part of the Asia Pacific Lupus Collaboration. Eligible patients were older than 18 years and fulfilled one of two classification criteria for SLE (1997 American College of Rheumatology criteria or the 2012 Systemic Lupus International Collaborating Clinics criteria). Visits were according to clinical need, with a minimum frequency of one visit per 6 months. We assessed attainment of remission on the basis of the eight DORIS definitions of remission, which varied in terms of serological activity, glucocorticoid use, and use of immunosuppresive agents; attainment of LLDAS; and disease flares at each visit. Irreversible organ damage accrual was recorded annually. Our primary aim was to assess exposure of patients to each of the remission definitions or LLDAS, and the respective association of these states with accrual of irreversible organ damage as the primary outcome measure. Occurrence of disease flares was the key secondary outcome. We used time-dependent Cox proportional hazards models and generalised linear models  to assess  DORIS definitions of  remission  and LLDAS  in terms  of their  association  with damage accrual and disease flares. Findings  Between May 1, 2013, and Dec 31, 2016, 1707 patients with SLE were recruited and followed for a mean of 2·2 years (SD 0·9), totalling 12 689 visits. Remission, depending on DORIS definition, was achieved in 581 (4·6%) to 4546 (35·8%) of 12 689 visits. Spending 50% or more of observed time in any remission state was associated with a significant reduction in damage accrual, except for the two most stringent remission definitions, for which the frequency of attainment was lowest. Remission definitions disallowing serological activity were associated with the greatest reductions in disease flares. LLDAS was more attainable than any remission definition and was associated with a similar magnitude of protection from damage accrual and disease flares. Sustained remission and LLDAS were associated with a wider spread of effect sizes for reduction in risk of damage.  By analysing patients who met the definition  for  LLDAS  but  not  remission,  we  found  that  LLDAS  was  significantly  associated  with reduction  in damage accrual, independent of all definitions of remission, except the least stringent. Interpretation  Attainment of remission was associated with significant reductions in damage accrual and disease f lares. LLDAS was more achievable than remission based on the DORIS criteria, but was similarly protective. Remission definitions with less stringency might be insufficiently distinct from LLDAS to substantially affect outcome measures, and further studies are needed to distinguish the protective effects of the various remission definitions. Funding  UCB, GlaxoSmithKline, Janssen, Bristol-Myers Squibb, and AstraZeneca.

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October 2019
1 Read

Lupus low disease activity state as a treatment endpoint for systemic lupus erythematosus: a prospective validation study

DOI: https://10.1016/S2665-9913(19)30037-2

Lancet Rheumatology

SummaryTreat-to-target  strategies  have  improved  outcomes  in  single-organ  diseases  with  simple  clinical  or laboratory endpoints. A lack of validated endpoints has prevented adoption of treat to target for complex multiorgan conditions, such as systemic lupus erythematosus (SLE). We report the first prospective study undertaken to specifically validate a treat-to-target endpoint for SLE. Methods  In this prospective cohort study, patients aged 18 years or older with SLE were recruited from 13 centres in eight countries and followed prospectively. Patients with at least two visits over the study period no more than 6 months apart were included in the longitudinal analysis. Patients with no visits in the final year of the study were censored  from  their  last  visit.  Attainment  of  the  lupus  low  disease  activity  state  (LLDAS)  was  assessed  at  each  visit. The primary outcome measure was accrual of irreversible end-organ damage, defined as at least a 1-point increase in the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index. We used time-dependent hazard regression models and generalised linear models to measure the association between LLDAS (attainment at any timepoint, cumulative time in LLDAS, and sustained LLDAS) with accrual of irreversible end-organ damage or flare (key secondary outcome). This study is registered with ClinicalTrials.gov, NCT03138941. Findings  Between May 1, 2013, and Dec 31, 2016, 1707 patients were recruited and followed for a mean of 2·2 years (SD 0·9), totalling 12 689 visits. Attainment of LLDAS at any timepoint was associated with reduction in damage accrual (0·59, 0·45–0·76; p

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September 2019

Biologic therapies in systemic lupus erythematosus.

Int J Rheum Dis 2015 Feb;18(2):146-53

University of Santo Tomas, Manila, Philippines.

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http://dx.doi.org/10.1111/1756-185X.12490DOI Listing
February 2015
15 Reads
1 Citation
1.771 Impact Factor

Top co-authors

Sandra V Navarra
Sandra V Navarra

University of Santo Tomas

5
Yuan An
Yuan An

Peking University People's Hospital

3
Worawit Louthrenoo
Worawit Louthrenoo

Chiang Mai University

3
Vera Golder
Vera Golder

Monash University

3
Rangi Kandane-Rathnayake
Rangi Kandane-Rathnayake

Monash University

3
Aisha Lateef
Aisha Lateef

National University Health System

3
Madelynn Chan
Madelynn Chan

Curtin University

3
Mandana Nikpour
Mandana Nikpour

Toronto Western Hospital

3
Chak Sing Lau
Chak Sing Lau

The University of Hong Kong

3
Fiona Goldblatt
Fiona Goldblatt

Rayne Institute

3