在增殖性狼性炎中,在完整的脏反应后停止免疫抑制治疗后的结果
Paola Vidal-Montal1,2, Javier Narváez3,2, Xavier Fulladosa2,4
1Department of Rheumatology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.
Lupus science & medicine
|January 20, 2025
概括
在精心挑选的个体中,在狼性炎 (LN) 患者中停止免疫抑制疗法 (IST) 是可行的. 大多数患者在性复发 (RR) 后重新引入IST后实现缓解.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 免疫学 免疫学 免疫学
- 类风湿病学 类风湿病学
背景情况:
- 增殖性狼性炎 (LN) 需要长期的免疫抑制疗法 (IST).
- 了解IST停药的风险和结果对于患者管理至关重要.
研究的目的:
- 确定在增殖性LN患者中停止IST后性复发 (RR) 的速率和预测因素.
- 评估这些患者在RR后的长期结局.
主要方法:
- 对76名通过活检确认的增殖性LN患者进行了回顾性研究,这些患者符合停止IST治疗的标准.
- 分析影响RR的因素和IST退出和重新引入后的结果.
主要成果:
- 38.2%的患者在IST戒断后平均26.5个月后经历了RR.
- 年龄较小 (≤34岁) 增加了RR风险,而较长的IST持续时间 (>48个月),持续的完全功能响应 (CRR) (≥48个月),DORIS缓解和逐渐缓解降低了RR风险.
- 在重新引入IST时,68.9%的患者实现了CRR,17.2%的部分反应,10.3%的患者进展到末期病.
结论:
- 精心挑选多发性LN患者,使得成功的IST退出.
- 大多数复发的患者在恢复IST后可以恢复缓解,这表明有利的长期结局.
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