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1.
Lupus Sci Med ; 11(2)2024 Jul 23.
Artículo en Inglés | MEDLINE | ID: mdl-39043606

RESUMEN

OBJECTIVES: To analyse the response to immunosuppressants (IS) in extrarenal flares of SLE to determine the most appropriate timing during follow-up for a change in therapeutic strategy. METHODS: Observational cohort study including a total of 81 patients with SLE with extrarenal flares requiring a change in IS over the period 2015-2022. Baseline clinical variables were described, and follow-up data at 1, 3, 6 and 12 months time-points were collected. RESULTS: Among patients flaring that achieved lupus low disease activity state (LLDAS5) at 12 months of follow-up, we identified two subgroups ('late responders' and 'early responders'), which showed no significant differences in demographic characteristics, baseline clinical data, cumulative dosage of glucocorticoids or type of IS. Cox model analysis revealed a significant association of a change in IS (p=0.019) and achieving LLDAS5. Contingency table analysis indicated a significant relationship (p=0.004) between IS change at 6 months and individuals achieving LLDAS5 and remission at 12 months. CONCLUSIONS: Our findings suggest that clinical improvement of extrarenal flares typically occurs within 6 months of initiating IS. This timeframe could represent an appropriate timing to evaluate the response in a treat-to-target approach in SLE.


Asunto(s)
Inmunosupresores , Lupus Eritematoso Sistémico , Humanos , Lupus Eritematoso Sistémico/tratamiento farmacológico , Femenino , Masculino , Inmunosupresores/uso terapéutico , Adulto , Persona de Mediana Edad , Factores de Tiempo , Glucocorticoides/uso terapéutico , Resultado del Tratamiento , Estudios de Cohortes , Índice de Severidad de la Enfermedad , Estudios de Seguimiento
2.
Clin Exp Rheumatol ; 42(5): 1104-1114, 2024 05.
Artículo en Inglés | MEDLINE | ID: mdl-38743446

RESUMEN

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a wide range of clinical manifestations and a relapsing-remitting course. SLE pathogenesis is the result of complex interactions between ethnic, genetic, epigenetic, immunoregulatory, hormonal and environmental factors, and several aspects of these multifactorial connections are still unclear. Overall, for the disease development, an environmental trigger may induce immunological dysfunction in genetically predisposed individuals. This review aims to summarise the most relevant data on the impact of environmental factors on the incidence of SLE and on disease activity and damage in patients with an established diagnosis of SLE.


Asunto(s)
Interacción Gen-Ambiente , Lupus Eritematoso Sistémico , Humanos , Lupus Eritematoso Sistémico/inmunología , Lupus Eritematoso Sistémico/genética , Lupus Eritematoso Sistémico/diagnóstico , Factores de Riesgo , Predisposición Genética a la Enfermedad , Incidencia , Exposición a Riesgos Ambientales/efectos adversos , Ambiente
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