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[The survival of patients with systemic lupus erythematosus]
Insights
Improved treatments significantly increased survival rates for patients with systemic lupus erythematosus (SLE). Modern therapeutic approaches, including antimalarials and corticosteroids, are key to better long-term outcomes for SLE patients.
Area of Science:
- Rheumatology
- Internal Medicine
- Clinical Research
Background:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with significant morbidity and mortality.
- Historical treatment approaches have shown variable efficacy in managing SLE progression.
- Understanding long-term outcomes and factors influencing survival is crucial for improving patient care.
Purpose of the Study:
- To compare the survival rates and causes of death in SLE patients treated during two distinct periods.
- To identify treatment strategies associated with improved survival in SLE.
- To analyze the correlation between patient age and disease evolution.
Main Methods:
- Retrospective cohort study of 146 SLE patients.
- Patients divided into two groups based on treatment period: 1953-1980 (Group I) and 1980-1987 (Group II).
- Analysis of survival data, causes of mortality, and treatment regimens.
Main Results:
- Survival rates dramatically improved from Group I (51% alive) to Group II (93% alive).
- Leading causes of death included lupus nephropathy, cardiovascular lesions, neurologic, and infectious complications.
- Younger age at diagnosis correlated with more rapid disease evolution.
- Effective SLE management in Group II involved antimalarial drugs, corticosteroids, azathioprine, and pulse therapy.
Conclusions:
- Modern treatment protocols, particularly the use of antimalarial and corticosteroid therapies, have significantly enhanced long-term survival in SLE patients.
- Early and aggressive management of SLE complications is vital.
- Continued research into optimal SLE treatment strategies is warranted to further reduce mortality.
Abstract:
146 patients with systemic lupus erythematodes were followed up. The patients are classified into two groups: I group--includes 74 patients treated during the 1953-1980. II group--of 72 patients treated during the period 1980-1987. Of the 74 patients of the I group 38 (51%) are still alive and 38 patients (49%) have died. From the II group 67 (93%) are alive and only 5 patients (7%) have died. 56% of the deceased patients died during the first 5 years. The following 5 years the death rate is twice as small--II dead patients (27%). Only 3 patients survived more than 15 years. The leading causes of death are: lupus nephropathy--18 patients (44%), cardiovascular lesions--12 patients (30%), neurologic complications and lately--infectious complications. A correlation between age and evolution of the disease is found: in younger age the evolution is more rapid. The analysis of the treatment of the patients from the II group reveals that the longer survival is due to the correct application of antimalarial drugs, cortisone drugs, imuran, pylse therapy with cortisone or a combination of these drugs.