Department of Rheumatology, Royal Blackburn Hospital, Haslingden Road, Blackburn.
School of Psychology.
Rheumatology (Oxford). 2021 Jul 1;60(7):3262-3267. doi: 10.1093/rheumatology/keaa777.
SLE is characterized by relapses and remissions. We aimed to describe the frequency, type and time to flare in a cohort of SLE patients.
SLE patients with one or more 'A' or 'B' BILAG-2004 systems meeting flare criteria ('new' or 'worse' items) and requiring an increase in immunosuppression were recruited from nine UK centres and assessed at baseline and monthly for 9 months. Subsequent flares were defined as: severe (any 'A' irrespective of number of 'B' flares), moderate (two or more 'B' without any 'A' flares) and mild (one 'B').
Of the 100 patients, 94% were female, 61% White Caucasians, mean age (s.d.) was 40.7 years (12.7) and mean disease duration (s.d.) was 9.3 years (8.1). A total of 195 flares re-occurred in 76 patients over 781 monthly assessments (flare rate of 0.25/patient-month). There were 37 severe flares, 32 moderate flares and 126 mild flares. By 1 month, 22% had a mild/moderate/severe flare and 22% had a severe flare by 7 months. The median time to any 'A' or 'B' flare was 4 months. Severe/moderate flares tended to be in the system(s) affected at baseline, whereas mild flares could affect any system.
. In a population with active SLE we observed an ongoing rate of flares from early in the follow-up period with moderate-severe flares being due to an inability to fully control the disease. This real-world population study demonstrates the limitations of current treatments and provides a useful reference population from which to inform future clinical trial design.
SLE 的特征是复发和缓解。我们旨在描述 SLE 患者队列中发作的频率、类型和时间。
从九个英国中心招募了一名或多名满足发作标准（“新”或“恶化”项目）且需要增加免疫抑制的 SLE 患者，并招募了一名或多名满足 BILAG-2004 系统“ A”或“ B”的 SLE 患者，并在基线和每月评估 9 个月。随后的发作定义为：严重（任何“ A”，无论“ B”发作次数如何）、中度（两个或更多“ B”，没有任何“ A”发作）和轻度（一个“ B”）。
在 100 名患者中，94%为女性，61%为白种高加索人，平均年龄（标准差）为 40.7 岁（12.7），平均病程（标准差）为 9.3 岁（8.1）。76 名患者在 781 次每月评估中共有 195 次发作复发（发作率为 0.25/患者-月）。有 37 例严重发作，32 例中度发作和 126 例轻度发作。在 1 个月时，22%的患者有轻度/中度/重度发作，22%的患者在 7 个月时有重度发作。任何“ A”或“ B”发作的中位数时间为 4 个月。严重/中度发作往往发生在基线时受影响的系统中，而轻度发作可能影响任何系统。
在活跃的 SLE 人群中，我们观察到在随访早期持续存在发作率，中度-重度发作是由于无法完全控制疾病。这项真实世界的人群研究表明了现有治疗方法的局限性，并为未来临床试验设计提供了有用的参考人群。
