Egyptian evidence-based consensus on clinical practice recommendations for the management of lupus nephritis

被引：1

作者：

El Miedany, Yasser ^{[1
]}

Kamel, Nadia Salah ^{[2
]}

Abu-Zaid, Mohammed Hassan ^{[3
]}

El Hadidi, Khaled ^{[4
]}

Mahmoud, Geilan Abdelmoneim ^{[4
]}

Sarhan, Eman ^{[5
]}

El Gaafary, Maha ^{[6
]}

Abdel-Nasser, Ahmed ^{[7
]}

Abualfadl, Esam M. ^{[8
]}

Azim, Atef Abdel ^{[9
,10
]}

Fathi, Nihal Ahmed ^{[11
]}

Mokbel, Abir ^{[4
]}

Hassan, Waleed ^{[12
]}

Tabra, Samar Abd Alhamed ^{[3
]}

Eissa, Mervat ^{[4
]}

Mortada, Mohamed ^{[13
]}

Fouad, Nermeen Ahmed ^{[14
]}

Elnemr, Rehab ^{[15
]}

Mansour, Ahmed Ezzat ^{[16
]}

Elaraby, Ismail ^{[17
,18
]}

Medhat, Basma M. ^{[4
]}

Mohamed, Sally S. ^{[4
]}

Abdelradi, Eman Ragab ^{[19
]}

Ibrahim, Rehab Ali ^{[2
]}

Saber, Sally ^{[2
]}

机构：

[1] Canterbury Christ Church Univ, Canterbury, Kent, England

[2] Ain Shams Univ, Rheumatol & Rehabil, Phys Med, Fac Med, Cairo, Egypt

[3] Tanta Univ, Rheumatol & Rehabil, Tanta, Egypt

[4] Cairo Univ, Rheumatol, Cairo, Egypt

[5] Ain Shams Univ, Nephrol, Cairo, Egypt

[6] Ain Shams Univ, Community & Publ Hlth, Cairo, Egypt

[7] Minia Univ, Rheumatol & Rehabil, Al Minya, Egypt

[8] Sohag Univ, Rheumatol, Sohag, Egypt

[9] Dr Erfan Hosp, Rheumatolgy Unit, Jeddah, Saudi Arabia

[10] Cairo Univ, Internal Med & Rheumatol, Cairo, Egypt

[11] Assiut Univ, Rheumatol & Rehabil, Assiut, Egypt

[12] Benha Univ, Rheumatol & Rehabil, Banha, Egypt

[13] Zagazig Univ, Rheumatol & Rehabil, Zagazig, Egypt

[14] Fayoum Univ, Rheumatol & Rehabil, Al Fayyum, Egypt

[15] Alexandria Univ, Rheumatol & Rehabil, Phys Med, Alexandria, Egypt

[16] Benha Univ, Internal Med & Nephrol, Banha, Egypt

[17] Minist Hlth Egypt, Nephrol, Cairo, Egypt

[18] Minist Hlth Cairo, Red Sea Govt, Cairo, Egypt

[19] South Valley Univ, Rheumatol & Rehabil, Qena, Egypt

来源：

EGYPTIAN RHEUMATOLOGY AND REHABILITATION | 2022年 / 49卷 / 01期

关键词：

Systemic lupus erythematosus; Lupus nephritis; Treat-to-target approach; Renal biopsy; Prognosis; Activity index; DAMAGE INDEX; DOUBLE-BLIND; ERYTHEMATOSUS; CYCLOPHOSPHAMIDE; MYCOPHENOLATE; GUIDELINES; MORTALITY; RITUXIMAB; EFFICACY; CLASSIFICATION;

D O I：

10.1186/s43166-022-00146-w

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background Lupus nephritis (LN) affects a substantial number of the patients living with Systemic lupus erythematosus (SLE), representing a major cause of morbidity and mortality. Patients with lupus nephritis should be referred to a lupus nephritis expert who can confirm the diagnosis, assess the level of disease activity, and offer guidance on treatment and monitoring of the disease, as well as its consequences and side effects. The aim of this guideline was to develop recommendations for the management of adult lupus patients, including lupus nephritis diagnosis, assessment, and monitoring. Nineteen key clinical questions were identified by scientific committee according to the Patient/Population, Intervention, Comparison, Outcomes and Timing (PICOT) approach. Literature review team performed a systematic review to summarize evidence advocating the benefits and harms of available pharmacologic and nonpharmacologic therapies for LN. Subsequently, recommendations were formulated. The level of evidence was determined for each section using the Oxford Centre for Evidence-based Medicine (CEBM) system. A 2-round Delphi process was conducted with 24 experts. All rounds were conducted online. A consensus was achieved on the direction and the strength of the recommendations. Results An online questionnaire was sent to an expert panel who participated in the two rounds (response rate 100%). At the end of round 2, a total of 19 recommendation items, categorized into 11 sections to address the main LN categories, were obtained. The percentage of those who agreed with the recommendations (ranks 7-9) ranged from 90.5 to 100%. The phrasing of all 19 clinical standards identified by the scientific committee was agreed upon (i.e., 75% of respondents strongly agreed or agreed). Conclusion These recommendations provide an updated consensus on the pharmacological treatment of lupus nephritis and strategies to reach optimal treat to target outcomes in common clinical scenarios, based on a combination of evidence and expert opinion. Best treatment decisions should be tailored to each individual patient situation.

引用

页数：14

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