Pawlak-Buś K, Schmidt W, Leszczyński P
Department of Internal Medicine, Poznań University of Medical Sciences, Poznań, Poland.
Eur Rev Med Pharmacol Sci. 2023 Feb;27(3):949-959. doi: 10.26355/eurrev_202302_31188.
Remission in systemic lupus erythematosus (SLE) or Lupus Low Disease Activity State (LLDAS) are associated with less organ damage and thus create new perspectives for effective damage-limiting treatment. The aim of this study was to assess the occurrence of remission defined by The Definition of Remission In SLE (DORIS) and of LLDAS as well as their predictors in the Polish SLE cohort.
In this retrospective study data were collected on patients with SLE that achieved at least one year of DORIS remission or LLDAS and were followed up for 5 years. Clinical and demographic data were gathered; DORIS and LLDAS predictors were determined by univariate regression analysis.
The full analysis set included 80 patients at baseline and 70 at follow-up. Over half of patients with SLE (39; 55.7%) fulfilled the DORIS remission criteria. In this group, 53.8% (21) of patients were in remission on-treatment and 46.1% (18) in remission off-treatment. LLDAS was fulfilled by a cohort of 43 (61.4%) patients with SLE. Among patients that achieved DORIS or LLDAS at follow-up, 77% were not treated with glucocorticoids (GCs). The most important predictors for DORIS and LLDAS off-treatment were mean SLEDAI-2K score with cut-off of ≤8.0, treatment with mycophenolate mofetil or antimalarials, and the age at disease onset above 43 years.
Remission and LLDAS are achievable goals in treating SLE as over half of study patients fulfilled the DORIS remission and LLDAS criteria. The identified predictors for DORIS and LLDAS indicate the importance of effective therapy leading to reduction of GC use.
系统性红斑狼疮(SLE)缓解或狼疮低疾病活动状态(LLDAS)与较少的器官损伤相关,从而为有效的损伤限制治疗带来新的前景。本研究的目的是评估波兰SLE队列中由SLE缓解定义(DORIS)定义的缓解和LLDAS的发生率及其预测因素。
在这项回顾性研究中,收集了达到至少一年DORIS缓解或LLDAS且随访5年的SLE患者的数据。收集了临床和人口统计学数据;通过单变量回归分析确定DORIS和LLDAS的预测因素。
完整分析集包括基线时的80例患者和随访时的70例患者。超过一半的SLE患者(39例;55.7%)符合DORIS缓解标准。在该组中,53.8%(21例)患者在治疗中缓解,46.1%(18例)患者在治疗后缓解。43例(61.4%)SLE患者达到LLDAS。在随访中达到DORIS或LLDAS的患者中,77%未接受糖皮质激素(GCs)治疗。治疗后DORIS和LLDAS的最重要预测因素是平均SLEDAI-2K评分≤8.0、霉酚酸酯或抗疟药治疗以及发病年龄大于43岁。
缓解和LLDAS是治疗SLE可实现的目标,因为超过一半的研究患者符合DORIS缓解和LLDAS标准。确定的DORIS和LLDAS预测因素表明有效治疗导致GC使用减少的重要性。