Arthritis Rheumatol:疾病早期和基线损害低预测SLE患者对贝利木单抗的反应

2020-04-14 xiangting MedSci原创

在现实生活中,活动性SLE患者早期使用贝利木单抗和基线损害低可以预测结局良好。

这项研究旨在探讨使用贝利木单抗治疗的系统性红斑狼疮(SLE)患者中,应答、缓解、低疾病活动性(LDA)、损害和停药的预测指标。

研究回顾性分析了一个静脉注射贝利木单抗治疗的多中心SLE患者队列的数据。评估达到缓解的患者比例、LDA和SLE 应答者指数-4(SRI-4)。每年计算SLICC损害指数(SDI)。通过多因素logistic回归分析结局的预测因子。

研究纳入来自意大利24个中心的466名活动性SLE患者:中位(范围)随访18(1-60)个月。第6、12、24、36和48个月时,分别有49.2%、61.3%、69.7%、69.6%和66.7%的患者达到SRI-4。6个月应答的基线预测指标是SLEDAI-2K≥10(OR 3.14,95%CI 2.033-4.860)和病程≤2年(OR 1.94,95%CI 1.078-3.473);12个月是SLEDAI-2K≥10(OR 3.48,95%CI 2.004-6.025),SDI=0(OR 1.74,95%CI 1.036-2.923);24个月是SLEDAI-2K≥10(OR 4.25,95%CI 2.018-8.940),病程≤2年(OR 3.79,95%CI 1.039-13.52);36个月是SLEDAI-2K≥10(OR 14.59,95%CI 3.54-59.79)和基线吸烟(OR 0.19,95%CI 0.039-0.69)。≥25%的随访期处于缓解状态的患者(42.9%)或≥50%为LDA的患者(66.0%)损害明显更少(p=0.046和p=0.007)。基线SDI=0独立预测LDA≥50%和缓解≥25%;基线损害越低,缓解≥25%的可能性越高。既往发作次数负向预测贝利木单抗因治疗无效的停药(p=0.009)。

在现实生活中,活动性SLE患者早期使用贝利木单抗和基线损害低可以预测结局良好。

原始出处:

Mariele Gatto. Early disease and low baseline damage predict response to belimumab in patients with systemic lupus erythematosus. Arthritis Rheumatol. 10 April 2020.

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    2020-04-16 zhaojie88

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