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难治性皮肤红斑狼疮的治疗进展

An update on the management of refractory cutaneous lupus erythematosus.

作者信息

Verdelli Alice, Corrà Alberto, Mariotti Elena Biancamaria, Aimo Cristina, Ruffo di Calabria Valentina, Volpi Walter, Quintarelli Lavinia, Caproni Marzia

机构信息

Section of Dermatology, Azienda USL Toscana Centro, Florence, Italy.

Section of Dermatology, University of Florence, Florence, Italy.

出版信息

Front Med (Lausanne). 2022 Sep 23;9:941003. doi: 10.3389/fmed.2022.941003. eCollection 2022.

DOI:10.3389/fmed.2022.941003
PMID:36213629
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9537468/
Abstract

Management of cutaneous lupus erythematosus (CLE) involves a combination of preventive measures, topical and systemic drugs, fairly similar for the different subtypes. Although guidelines exist, to date, no specific drugs have been specifically licensed for CLE. Antimalarials remain the first-line systemic treatment, but many patients do not respond, making refractory lupus a challenge for clinicians. The choice of alternative medication should be based on effectiveness, safety and cost. Most of the available drugs for CLE have been adapted from systemic lupus erythematosus (SLE) treatment but the existing literature is limited to small studies and evidence often lacks. As knowledge of pathogenesis of both CLE and SLE is improving, promising new therapies are emerging. In this review, we discuss the available medications, focusing on the novelties under development for CLE.

摘要

皮肤型红斑狼疮(CLE)的管理涉及预防措施、局部和全身用药的联合使用,不同亚型的治疗方法相当相似。尽管有相关指南,但迄今为止,尚无专门针对CLE获批的特定药物。抗疟药仍然是一线全身治疗药物,但许多患者对此无反应,这使得难治性狼疮成为临床医生面临的一项挑战。替代药物的选择应基于有效性、安全性和成本。大多数现有的用于CLE的药物是从系统性红斑狼疮(SLE)治疗中改编而来的,但现有文献仅限于小型研究,且证据往往不足。随着对CLE和SLE发病机制的认识不断提高,有前景的新疗法正在出现。在本综述中,我们讨论了可用的药物,重点关注正在研发的针对CLE的新药物。

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本文引用的文献

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Type I interferon inhibitor anifrolumab in active systemic lupus erythematosus (TULIP-1): a randomised, controlled, phase 3 trial.I型干扰素抑制剂阿尼鲁单抗治疗活动性系统性红斑狼疮(TULIP-1):一项随机、对照、3期试验
Lancet Rheumatol. 2019 Dec;1(4):e208-e219. doi: 10.1016/S2665-9913(19)30076-1. Epub 2019 Nov 11.
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Prevalence and factors associated with long-term remission in cutaneous lupus: A longitudinal cohort study of 141 cases.皮肤狼疮长期缓解的患病率及相关因素:一项对 141 例病例的纵向队列研究。
J Am Acad Dermatol. 2022 Aug;87(2):323-332. doi: 10.1016/j.jaad.2022.03.056. Epub 2022 Apr 4.
3
Thalidomide and discoid lupus erythematosus: case series and review of literature.沙利度胺与盘状红斑狼疮:病例系列及文献综述
Drugs Context. 2022 Mar 16;11. doi: 10.7573/dic.2021-9-8. eCollection 2022.
4
Acitretin treatment in antimalarial-refractory/intolerant discoid lupus erythematosus: A prospective, open-label, uncontrolled study.阿维 A 治疗抗疟药难治/不耐受盘状红斑狼疮:一项前瞻性、开放标签、非对照研究。
Lupus. 2022 Apr;31(5):575-581. doi: 10.1177/09612033221086878. Epub 2022 Mar 20.
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