针对系统性红斑狼的管理EULAR建议:2023年更新
Antonis Fanouriakis1, Myrto Kostopoulou1, Jeanette Andersen2
1Rheumatology and Clinical Immunology Unit, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Annals of the rheumatic diseases
|October 12, 2023
概括
更新的EULAR建议指导系统性红斑狼 (SLE) 管理,强调氧化 (HCQ) 的使用和尽量减少糖皮质类药物 (GC). 新的指导方针支持及时使用免疫抑制剂和生物药物来控制疾病并减少GC依赖.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 内部医学 内部医学
背景情况:
- 系统性红斑狼 (SLE) 是一种复杂的自身免疫性疾病,需要更新的管理策略.
- 新出现的证据需要对现有的欧洲风湿病协会联盟 (EULAR) 关于SLE治疗的建议进行修订.
研究的目的:
- 为SLE的管理提供最新的,基于证据的建议.
- 将新的治疗药物和策略纳入临床实践指南.
主要方法:
- 对2018年1月至2022年12月期间发表的证据进行了系统的文献审查.
- 一个国际特别工作组制定了建议,采用了预先定义的投票过程,并分配了证据水平和建议的强度.
主要成果:
- 制定了五项总体原则和13项建议,涵盖氧化 (HCQ),葡萄糖皮质类药物 (GC),免疫抑制药物 (ISD),氨酸抑制剂 (CNIs) 和生物药物.
- 建议强调所有患者的HCQ,最低限度的GC使用 (≤5毫克/天的普雷尼松等效),及时启动ISD或生物药物以促进GC逐渐减少.
- 针对狼性炎,皮肤性,神经精神和血液性SLE,抗脂综合征以及预防措施提供了具体指导.
结论:
- 更新的EULAR建议为SLE管理提供了基于共识的指导.
- 这些指南将最新的科学证据与专家临床意见相结合,以优化患者护理.
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