Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 46285, USA.
Syneos Health, Morrisville, USA.
Adv Ther. 2022 Jul;39(7):3131-3145. doi: 10.1007/s12325-022-02148-8. Epub 2022 May 9.
Musculoskeletal (MSK) symptoms, including arthritis and arthralgia, are common manifestations of systemic lupus erythematosus (SLE); definitions of activity patterns in SLE differ across studies. This study described clinical characteristics and treatment patterns of patients with SLE-MSK over time and by disease activity patterns from a real-world setting.
This retrospective descriptive analysis includes a subset of patients with SLE from the Hopkins Lupus Cohort with identified MSK involvement by scores on the arthritis domain of the Safety of Estrogens in Systemic Lupus Erythematosus National Assessment-Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI) or Lupus Activity Index. Clinical characteristics and treatment patterns were described for patients with at least two visits over the observation period (2010-2019) for the SLE-MSK population based on three disease activity patterns: chronically active (MSK-CA), relapsing-remitting (MSK-RR), and long quiescence (MSK-LQ).
The SLE-MSK subpopulation included 664 patients (4069 person-years). The most frequently used medications over the observation period were antimalarials (95%), corticosteroids (92%), immunosuppressants (58%), and nonsteroidal anti-inflammatory drugs (NSAIDs) (48%); 7% of patients used biologics. The highest use of corticosteroids was in the MSK-CA group (90.5% of follow-up time), followed by MSK- RR (83.9%), and MSK-LQ (46.5%). Mean prednisone dose was significantly higher in MSK-RR (8.5 mg) compared to MSK-CA (6.5 mg).
This descriptive analysis highlights the impact of prevalent manifestations such as arthritis on the chronic use of corticosteroids, immunosuppressants, and NSAIDs to manage disease activity in patients with SLE, suggesting there is a need for new therapeutic options that enable a lower use of medication when treating lupus.
肌肉骨骼（MSK）症状，包括关节炎和关节痛，是红斑狼疮（SLE）的常见表现；SLE 中的活动模式定义在不同的研究中有所不同。本研究从真实世界的角度描述了 SLE-MSK 患者随时间推移的临床特征和治疗模式，以及根据疾病活动模式的变化。
本回顾性描述性分析包括霍普金斯狼疮队列中通过关节炎域评分确定有 MSK 受累的 SLE 患者亚组，该评分来自雌激素在系统性红斑狼疮中的安全性评估-系统性红斑狼疮疾病活动指数（SELENA-SLEDAI）或狼疮活动指数。根据三种疾病活动模式，描述了至少有两次就诊的 SLE-MSK 患者的临床特征和治疗模式：慢性活动性（MSK-CA）、复发性缓解性（MSK-RR）和长期静止性（MSK-LQ）。
SLE-MSK 亚组包括 664 名患者（4069 人年）。在观察期间，最常用的药物是抗疟药（95%）、皮质类固醇（92%）、免疫抑制剂（58%）和非甾体抗炎药（48%）；7%的患者使用生物制剂。皮质类固醇的使用最高的是 MSK-CA 组（90.5%的随访时间），其次是 MSK-RR（83.9%），MSK-LQ（46.5%）。MSK-RR 组的平均泼尼松剂量（8.5mg）明显高于 MSK-CA 组（6.5mg）。
这项描述性分析强调了关节炎等常见表现对慢性使用皮质类固醇、免疫抑制剂和 NSAIDs 来治疗 SLE 患者疾病活动的影响，表明需要新的治疗选择，以便在治疗狼疮时减少药物的使用。
