2024年APLAR关于狼性炎管理的共识
Chi Chiu Mok1, Ho So2, Laniyati Hamijoyo3
1Department of Medicine, Tuen Mun Hospital, Hong Kong, SAR, China.
International journal of rheumatic diseases
|January 2, 2025
概括
更新的APLAR关于狼性炎 (LN) 管理的建议强调初始治疗是用葡萄糖皮质类药物加环胺,甲酸或氨酸抑制剂. 至少三年的维持治疗对于预防系统性红斑狼患者的发作至关重要.
科学领域:
- 类风湿病学 类风湿病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 免疫学 免疫学 免疫学
背景情况:
- 亚太风湿病学协会联盟 (APLAR) 此前在2021年发布了SLE管理指南.
- 狼性炎 (LN) 管理需要具体的,更新的建议,因为它对系统性红斑狼 (SLE) 的功能的影响.
研究的目的:
- 为狼性炎 (LN) 管理提供最新的,基于证据的共识建议.
- 补充和完善2021年APLAR指南,特别关注LN治疗策略.
主要方法:
- 一个德尔菲演习,涉及APLAR SLE特殊兴趣小组成员,科医生,组织病理学家和LN患者.
- 审查和综合现有证据,考虑亚洲患者数据,成本效益和区域医疗保健差异.
主要成果:
- 最初的LN治疗建议使用葡萄糖皮质类药物 (GCs) 与环胺 (CYC),甲酸 (MMF) 或氨酸抑制剂 (CNIs) 结合.
- 在高风险患者中,可以考虑使用生物药物的前期联合治疗.
- 建议至少3年使用低剂量的MMF或阿扎西奥普林和低剂量的普雷尼索隆 (≤5毫克/天) 进行维持治疗,以预防炎.
结论:
- 该共识提供了对LN管理的务实方法,整合了辅助疗法,监测和并发症治疗.
- 建议考虑区域因素,如亚太地区的成本效益和医疗保健资源.
- 这些指导方针旨在优化的结果,并减少LN患者的疾病爆发.
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