在埃及狼性炎患者中高剂量和低剂量环胺:多中心回顾性分析
Mohamed Momtaz A Elaziz1, Sherif M Gamal2, Ahmed Fayed1
1Department of Internal Medicine, Nephrology Unit, Cairo University Hospital, Cairo, Egypt.
Zeitschrift fur Rheumatologie
|August 15, 2023
概括
48个月后,高剂量环胺 (CYC) 显示出比低剂量CYC更好的狼性炎缓解率. 将高剂量CYC诱导与mycophenolate mofetil维持相结合,在埃及患者中产生了最佳的结果.
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.
- 环胺 (CYC) 和菌酸莫菲蒂尔 (MMF) 是对LN的标准诱导疗法.
研究的目的:
- 为了比较高剂量与低剂量CYC在埃及LN患者的诱导疗法的疗效.
- 评估长期结果,包括功能和蛋白尿尿缓解.
主要方法:
- 对547名埃及患者的回顾性分析,这些患者患有III/IV类活跃的LN.
- 患者接受了每6个月高剂量CYC (0.5-1 g/m2) 或每两周六次低剂量CYC (500 mg) 剂量.
- 人口统计数据,实验室结果和疾病活性在基线和48个月后进行了比较.
主要成果:
- 高剂量的CYC与48个月内维持正常肌水平的患者比例显著增加 (67.9%与60.4%相比).
- 在高剂量CYC下,在36个月 (26.6%对14.8%) 和48个月 (24.3%对12.8%) 观察到更高的蛋白尿缓解率.
- 通过高剂量的CYC诱导,然后进行MMF维持疗法,获得了最好的结果.
结论:
- 虽然高剂量和低剂量CYC在早期治疗阶段是可比的,但高剂量CYC在LN中显示出更高的长期缓解率.
- 高剂量的CYC诱导与MMF维护相结合,为狼性炎管理提供了最有利的结果.
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