Department of Rheumatology, Hôpitaux Universitaires de Strasbourg, INSERM UMR-S 1109, Centre National de Référence des Maladies Auto-immunes Systémiques Rares (RESO), Strasbourg, France.
Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Joint Rheumatology Program, Laiko Hospital, Athens, Greece.
Rheumatology (Oxford). 2020 Dec 5;59(Suppl5):v29-v38. doi: 10.1093/rheumatology/keaa382.
SLE is a chronic autoimmune rheumatic disorder of high heterogeneity in clinical presentation, treatment response and prognosis. Long-term outcomes in SLE have been dramatically improved over the past decades, however, increased morbidity and mortality, especially among young individuals, still exists. Unmet needs include residual disease activity and frequent flares, glucocorticoid treatment dependency and toxicity, comorbidity burden, reduced health-related quality of life, health disparities and damage. The main determinants of long-term outcomes in SLE are age, sex, race/ethnicity, genetic profile, environmental factors including smoking, disease activity, major organ involvement such as lupus nephritis and CNS involvement, comorbidities including cardiovascular disease and serious infections, coexistence with APS, treatment adherence, socio-economic factors and access to care. In this review we discuss trends in long-term outcomes in SLE over the years and major contributors such as genetic, disease-related, treatment, comorbidity, socio-economic and other factors.
SLE 是一种慢性自身免疫性风湿性疾病，临床表现、治疗反应和预后高度异质性。过去几十年中，SLE 的长期预后已显著改善，但发病率和死亡率仍在增加，尤其是在年轻人中。未满足的需求包括疾病活动残留和频繁发作、糖皮质激素治疗依赖和毒性、合并症负担、健康相关生活质量下降、健康差异和损害。SLE 长期预后的主要决定因素包括年龄、性别、种族/民族、遗传特征、环境因素（包括吸烟）、疾病活动、主要器官受累（如狼疮肾炎和中枢神经系统受累）、合并症（包括心血管疾病和严重感染）、APS 共存、治疗依从性、社会经济因素和获得医疗保健。在这篇综述中，我们讨论了多年来 SLE 长期预后的趋势以及主要的影响因素，如遗传、疾病相关、治疗、合并症、社会经济和其他因素。
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