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幼年特发性关节炎的低疾病活动状态。

Low disease activity state in juvenile-onset systemic lupus erythematosus.

机构信息

Department of Pediatric Rheumatology, Goztepe Prof. Dr Suleyman Yalcın City Hospital, Istanbul Medeniyet University, Istanbul, Turkey.

Department of Pediatric Rheumatology, University of Health Sciences, Umraniye Research and Training Hospital, Istanbul, Turkey.

出版信息

Lupus. 2021 Nov;30(13):2144-2150. doi: 10.1177/09612033211054399. Epub 2021 Nov 1.

Abstract

OBJECTIVES

To determine the rate of achieving The Lupus Low Disease Activity State (LLDAS) in children with systemic lupus erythematosus (SLE) for tracing pertinent treatment modalities.

METHODS

A total of 122 juvenile-onset SLE (jSLE) patients from six pediatric rheumatology centers in Turkey were enrolled in the study. LLDAS-50 was defined as encountering LLDAS for at least 50% of the observation time. According to the achievement of LLDAS-50, clinical features, immunological profiles, and treatments of patients with jSLE have been revealed.

RESULTS

LLDAS of any duration was achieved by 82% of the cohort. Although only 10.8% of the patients achieved remission, 68.9% reached LLDAS-50. A significant difference was found between patients who reached LLDAS-50 and those who did not, in terms of the time to reach low-dose corticosteroid treatment ( = 0.002), the presence of subacute cutaneous findings ( = 0.007), and the presence of proteinuria ( = 0.002). Both of the groups were under similar treatment approaches. However, the number of patients being treated with corticosteroids at the last visit was found to be significantly higher in patients who achieved LLDAS-50 (<0.001).

CONCLUSION

Targeting LLDAS in jSLE, even with long-term, low-dose corticosteroid use, seems to be an achievable goal in clinical practice.

摘要

目的

确定幼年特发性系统性红斑狼疮(jSLE)患儿达到狼疮低疾病活动状态(LLDAS)的比例,以追踪相关治疗方法。

方法

本研究纳入了土耳其 6 个儿科风湿病中心的 122 名 jSLE 患者。定义 LLDAS-50 为至少 50%的观察时间内达到 LLDAS。根据达到 LLDAS-50 的情况,揭示了 jSLE 患者的临床特征、免疫特征和治疗方法。

结果

82%的患者达到了任何持续时间的 LLDAS。尽管只有 10.8%的患者达到了缓解,但 68.9%的患者达到了 LLDAS-50。达到 LLDAS-50 的患者与未达到 LLDAS-50 的患者在达到低剂量皮质类固醇治疗的时间(=0.002)、存在亚急性皮肤表现(=0.007)和蛋白尿存在(=0.002)方面存在显著差异。两组患者接受的治疗方法相似。然而,在最后一次就诊时,达到 LLDAS-50 的患者接受皮质类固醇治疗的患者数量明显更高(<0.001)。

结论

即使长期使用低剂量皮质类固醇,在 jSLE 中靶向 LLDAS 似乎也是临床实践中可以实现的目标。

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