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在全身性红斑狼中停用葡萄糖皮质类药物:单中心研究

Yaqi Zhang¹, Hanyin Deng¹, Daidi Chen¹

¹Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, Clinical College of Nanjing University of Chinese Medicine, Nanjing, China.

Rheumatology advances in practice

|May 9, 2025

概括

大多数系统性红斑狼 (SLE) 患者在葡萄糖皮质类药物 (GCs) 戒断后复发,在五年内出现高发病率. 自行中止和先前的器官损伤预测复发,大多数患者在一年内恢复缓解或低疾病活性.

科学领域:

类风湿病学类风湿病学
免疫学免疫学免疫学
临床医学临床医学

背景情况:

系统性红斑狼 (SLE) 管理通常涉及葡萄皮质类药物 (GCs).
停用GC可以导致疾病爆发或复发.
了解复发率和风险因素对于患者管理至关重要.

研究的目的:

为了确定SLE患者在停止使用GC后的复发率.
为了确定与SLE复发后GC退出相关的风险因素.
为了评估复发的患者的结果.

主要方法:

对217名在2017-2022年期间停止使用GC的SLE患者的回顾性分析.
考克斯回归和卡普兰-梅尔模型来评估复发率和预测因素.
对复发患者的缓解和狼低疾病活动状态 (LLDAS) 成绩的分析.

主要成果:

在217名患者中,有166名患者 (76.5%) 在停用GC后复发.
一年后的累计非复发率为57.3%,三年后为19.6%,五年后为7.8%.
复发的独立预测因素包括自我停止,先前的/肺功能障碍和阳性抗dsDNA抗体. 21.1%的人在复发后12个月内实现了缓解,54.2%的人在复发后12个月内实现了LLDAS.

结论:

大多数SLE患者在GC撤销后的长期稳定对大多数SLE患者来说具有挑战性.
在停用GC之前,对复发风险因素的早期评估至关重要.
虽然许多患者恢复缓解或LLDAS,但特定的临床和血清学因素与较低的缓解率有关.

关键词:

一个小小的东西.葡萄糖皮质类药物预后预后预后这是一个复发的复发.风险因素风险因素

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