系统性红斑狼的疾病修饰疗法用于外表现
Anca D Askanase1, Richard A Furie2, Maria Dall'Era3
1Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA.
Lupus science & medicine
|May 22, 2024
概括
这次审查评估了系统性红斑狼 (SLE) 疾病修饰治疗方法,发现贝利马布符合所有标准. 氧化也显示出长期益处,但其他SLE疗法需要进一步研究.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 建立了2022年系统性红斑狼 (SLE) 疾病修饰的定义,重点是尽量减少活性和毒性,同时防止器官损伤.
- 根据这一定义,根据目前的SLE治疗方法进行分类,特别是排除毒性,排除非病修饰,对于有效的患者管理至关重要.
研究的目的:
- 根据建议的非脏疾病修改标准对14种SLE药物进行分类,不包括治疗毒性.
- 评估SLE治疗在三个不同的时间点中的疾病修饰潜力:1年,2-5年和>5年.
主要方法:
- 对32项临床试验和54项关于14种SLE药物的观察性研究进行了系统审查.
- 基于包括减少非脏疾病活动,严重爆发,使用类固醇/免疫抑制剂和器官损伤累积等标准的治疗方法的评估.
- 将处理分为四类:符合标准,符合标准的说明,不确定的或没有数据,在每个时间点.
主要成果:
- 在14种评估的SLE治疗中,有8种满足了至少一个疾病修改标准,长达5年.
- 贝利马布是唯一符合所有疾病修饰标准的治疗方法.
- 贝利马布和氧化在所有三个评估时间点都符合标准;氧化证明了改善了5年以上的存活率.
结论:
- 根据既定的标准,贝利穆马布和基氨酸在SLE中显示出显著的疾病修饰潜力.
- 关于其他SLE疗法的疾病修饰潜力的证据是不完整的,特别是在长期影响 (>5年) 方面.
- 需要进一步的研究来充分评估和分类各种SLE治疗方法的疾病修饰能力,并可能完善现有的标准.
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