在现实生活环境中,在狼性炎患者中实现疾病修饰:任务不可能吗?
Alexandros Panagiotopoulos1, Eleni Kapsia2, Ioannis Michelakis3
1Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Joint Academic Rheumatology Program, Laiko Hospital, Medical School, National and Kapodistrian University, Athens, Greece.
RMD open
|June 12, 2023
概括
在狼性炎 (LN) 中,60%的患者实现了疾病修饰 (DM),较低的比率与更糟糕的结局有关. 这强调了需要改进的LN治疗方法和新的策略.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 免疫学 免疫学 免疫学
- 类风湿病学 类风湿病学
背景情况:
- 狼性炎 (LN) 是系统性红斑狼的一个严重表现.
- 在LN中,已经建立了疾病修饰 (DM) 的初步定义,重点是缓解和预防损伤.
- 在现实环境中评估DM成就对于评估治疗疗效至关重要.
研究的目的:
- 为了完善狼性炎的DM标准.
- 在现实世界患者队列中评估DM成就.
- 为了确定DM的预测因子,并分析长期的结局.
主要方法:
- 活检证明的LN初始队列的回顾性分析,随访超过72个月.
- 在三个时间框架内应用蛋白尿,eGFR,炎和葡萄糖皮质体剂量的特定标准.
- 使用后勤回归来识别DM预测因素;还研究了DM成就的历史趋势.
主要成果:
- 60%的患者获得了DM,当排除葡萄糖皮质类药物标准时,增加到70%.
- 9个月后24小时较低的蛋白尿预测了DM的实现.
- 与成功者相比,不成功者经历了更糟糕的长期脏结果.
- 最近 (2006年至2016年) 诊断的患者比早期 (1992年至2005年) 队列更高的DM成功率.
结论:
- 在现实环境中,有限比例的LN患者获得了DM,这通常是由于满足葡萄糖皮质激素标的挑战.
- 无法实现DM与较差的长期结局相关.
- 研究结果表明,目前的LN治疗策略可能存在局限性,强调需要新的治疗方法.
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