Huang Jinxian, Song Guoxiang, Yin Zhihua, He Weizhen, Zhang Lijun, Kong Weihong, Ye Zhizhong
Rheumatology Department, The Fourth People's Hospital of Shenzhen, Shenzhen, China.
Rheumatology Department, The University of Hong Kong-Shenzhen Hospital, Haiyuan Road, Shenzhen, 518000, China.
Clin Rheumatol. 2016 Sep;35(9):2211-8. doi: 10.1007/s10067-016-3354-2. Epub 2016 Aug 3.
This was an exploratory analysis comparing the safety and efficacy of immunoadsorption (IAS) combination therapy in severe systemic lupus erythematosus (SLE) receiving corticosteroid pulse and immunosuppressant treatment. Patients enrolled all had predominant organ involvement including proteinuria, thrombocytopenia, pericardial effusion, and cerebral involvement requiring corticosteroid pulse treatment. Fifty-two patients in study group received IAS plus corticosteroid and cyclophosphamide treatment. Fifty-two patients in non-IAS group received corticosteroid and cyclophosphamide treatment. Outcome measurement included C3, dsDNA, AnuA, and SLE disease activity index (SLEDAI) 2k score and in particular cases, proteinuria quantification and platelet count. Disease activity dropped significantly in both groups. Improvement of disease activity markers was more significant in study group than that in non-IAS group. The lower dosage of steroid in study group suggested the steroid-sparing effect of IAS. No severe adverse effect occurred during IAS. Our study suggested IAS as an additional therapy to steroid pulse and immunosuppressant in treating severe SLE.
这是一项探索性分析，比较免疫吸附（IAS）联合疗法在接受糖皮质激素冲击和免疫抑制剂治疗的重症系统性红斑狼疮（SLE）中的安全性和有效性。入选患者均有主要器官受累，包括蛋白尿、血小板减少、心包积液以及需要糖皮质激素冲击治疗的脑部受累。研究组52例患者接受IAS联合糖皮质激素和环磷酰胺治疗。非IAS组52例患者接受糖皮质激素和环磷酰胺治疗。疗效指标包括C3、双链DNA、抗核小体抗体（AnuA）以及SLE疾病活动指数（SLEDAI）2k评分，特殊病例还包括蛋白尿定量和血小板计数。两组疾病活动度均显著下降。研究组疾病活动指标的改善比非IAS组更显著。研究组糖皮质激素剂量较低，提示IAS具有激素节省效应。IAS治疗期间未发生严重不良反应。我们的研究表明，IAS可作为糖皮质激素冲击和免疫抑制剂治疗重症SLE的一种辅助疗法。
