Real world treatment of juvenile-onset systemic lupus erythematosus: Data from the UK JS']JSLE cohort study

被引：14

作者：

Smith, Eve M. D. ^{[1
,2
]}

Egbivwie, Naomi ^{[1
,2
,3
]}

Jorgensen, Andrea L. ^{[4
]}

Ciurtin, Coziana ^{[5
]}

Al-Abadi, Eslam ^{[6
]}

Armon, Kate ^{[7
]}

Bailey, Kathryn ^{[8
]}

Brennan, Mary ^{[9
]}

Gardner-Medwin, Janet ^{[10
]}

Haslam, Kirsty ^{[11
]}

Hawley, Daniel P. ^{[12
]}

Leahy, Alice ^{[13
]}

Leone, Valentina ^{[14
]}

Malik, Gulshan ^{[15
]}

McLaren, Zoe ^{[3
]}

Pilkington, Clarissa ^{[16
]}

Ramanan, Athimalaipet V. ^{[17
,18
]}

Rangaraj, Satyapal ^{[19
]}

Ratcliffe, Annie ^{[20
]}

Riley, Phil ^{[21
]}

Sen, Ethan ^{[22
]}

Sridhar, Arani ^{[23
]}

Wilkinson, Nick ^{[24
]}

Wood, Fiona ^{[25
]}

Beresford, Michael W. ^{[1
,2
]}

Hedrich, Christian M. ^{[1
,2
]}

机构：

[1] Univ Liverpool, Inst Life Course & Med Sci, Dept Womens & Childrens Hlth, Liverpool, Merseyside, England

[2] Alder Hey Childrens NHS Fdn Trust Hosp, Dept Paediat Rheumatol, Liverpool, Merseyside, England

[3] Liverpool Univ Hosp NHS Fdn Trusts, Liverpool, Merseyside, England

[4] Univ Liverpool, Dept Biostat, Liverpool, Merseyside, England

[5] UCL, Ctr Adolescent Rheumatol, London, England

[6] Birmingham Childrens Hosp, Dept Rheumatol, Birmingham, W Midlands, England

[7] Cambridge Univ Hosp, Dept Paediat Rheumatol, Cambridge, England

[8] Oxford Univ Hosp NHS Fdn Trust, Dept Paediat Rheumatol, Oxford, England

[9] Royal Hosp Sick Children, Dept Paediat Rheumatol, Edinburgh, Midlothian, Scotland

[10] Univ Glasgow, Dept Child Hlth, Glasgow, Lanark, Scotland

[11] Bradford Royal Infirm, Dept Paediat, Bradford, W Yorkshire, England

[12] Sheffield Childrens Hosp, Dept Paediat Rheumatol, Sheffield, S Yorkshire, England

[13] Southampton Gen Hosp, Dept Paediat Rheumatol, Southampton, Hants, England

[14] Leeds Children Hosp, Dept Paediat Rheumatol, Leeds, W Yorkshire, England

[15] Royal Aberdeen Childrens Hosp, Paediat Rheumatol, Aberdeen, Scotland

[16] Great Ormond St Hosp Sick Children, Dept Paediat Rheumatol, London, England

[17] Univ Hosp Bristol NHS Fdn Trust, Bristol, Avon, England

[18] Univ Bristol, Bristol Med Sch, Bristol, Avon, England

[19] Nottingham Univ Hosp, Dept Paediat Rheumatol, Nottingham, England

[20] Taunton & Somerset NHS Fdn Trust, Dept Paediat, Musgrove Pk Hosp, Taunton, Somerset, England

[21] Royal Manchester Childrens Hosp, Paediat Rheumatol, Manchester, Lancs, England

[22] Newcastle Univ, Paediat Rheumatol, Great North Childrens Hosp, Royal Victoria Infirm,Inst Cellular Med, Newcastle Upon Tyne, Tyne & Wear, England

[23] Univ Hosp Leicester NHS Trust, Leicester Childrens Hosp, Leicester, Leics, England

[24] Guys & St Thomass NHS Fdn Trust, Evelina Childrens Hosp, London, England

[25] Univ Hosp Morecambe Bay NHS Fdn Trust, Dept Paediat, Royal Lancaster Infirm, Lancaster, England

来源：

CLINICAL IMMUNOLOGY | 2022年 / 239卷

关键词：

SLE; Childhood; Juvenile-onset SLE; Treatment; Immunosuppression; EVIDENCE-BASED RECOMMENDATIONS; CLINICAL-DISEASE ACTIVITY; CHILDHOOD-ONSET; MYCOPHENOLATE-MOFETIL; REVISED CRITERIA; BILAG INDEX; NEPHRITIS; DAMAGE; RHEUMATOLOGY; RITUXIMAB;

D O I：

10.1016/j.clim.2022.109028

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background: In the absence of clinical trials evidence, Juvenile-onset Systemic Lupus Erythematosus (JSLE) treatment plans vary. Aim: To explore 'real world' treatment utilising longitudinal UK JSLE Cohort Study data. Methods: Data collected between 07/2009-05/2020 was used to explore the choice/sequence of immunomodulating drugs from diagnosis. Multivariate logistic regression determined how organ-domain involvement (pBILAG-2004) impacted treatment choice. Result: 349 patients met inclusion criteria, median follow-up 4-years (IQR:2,6). Mycophenolate mofetil (MMF) was most commonly used for the majority of organ-domains, and significantly associated with renal involvement (OR:1.99, 95% CI:1.65-2.41, p(c) < 0.01). Analyses assessing the sequence of immunomodulators focused on 197/ 349 patients (meeting relevant inclusion/exclusion criteria). 10/197 (5%) solely recieved hydroxychloroquine/ prednisolone, 62/197 (31%) received a single-immunomodulator, 69/197 (36%) received two, and 36/197 patients (28%) received >= three immunomodulators. The most common first and second line immunomodulator was MMF. Rituximab was the most common third-line immunomodulator. Conclusions: Most UK JSLE patients required >= two immunomodulators, with MMF used most commonly.

引用

页数：10

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