Arthritis Rheumatol:利妥昔单抗作为系统性红斑狼疮维持治疗的观察性研究

2019-05-21 xiangting MedSci原创

RMT是难治性患者的潜在治疗选择。首次RTX时有活动性关节病的患者更容易在RMT期间复发。

利妥昔单抗(RTX)对系统性红斑狼疮(SLE)的疗效存在争议。这项研究旨在描述一个欧洲SLE队列使用RTX治疗的结局,重点是其作为维持期用药的作用。

纳入在4个中心接受RTX作为诱导治疗的所有SLE患者,RTX后进行随访,其中包括使用RTX作为维持治疗(RMT)的亚组。随访期间的急性发作定义为疾病活动性和免疫抑制药物的增加。

在147名患者中,6个月时27%的患者经历了治疗失败(TF),在多因素分析中,既往免疫抑制治疗的次数少(p=0.034)和C4水平低(p=0.008)降低了TF风险。80名患者接受了RMT,中位时间24.5个月,其中记录了85次复发(每位患者1.06),主要为肌肉骨骼性,在最后一个RTX疗程中,84%的患者处于缓解期。28/80名(35%)患者在RMT期间从未出现急性发作,并且损伤率低。第一个RTX疗程时的活动性关节病与RMT期间的急性发作风险相关(p=0.010)。RMT后的无复发生存率与接受单RTX疗程的患者相似(p=0.72)。

RMT是难治性患者的潜在治疗选择。首次RTX时有活动性关节病的患者更容易在RMT期间复发。RMT后的复发风险仍然很高,并与单RTX疗程后的风险相当。

原始出处:

Matthias A. Cassia. Rituximab as maintenance treatment for systemic Lupus ErythematosusA multicentre observational study of 147 patients. Arthritis Rheumatol. 18 May 2019.

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    2019-05-23 zhaojie88
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    2019-05-23 zhouqu_8
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