Tapering and termination of immunosuppressive therapy. Systemic lupus erythematosus

被引：2

作者：

Aringer, M. ^{[1
,2
,4
]}

Leuchten, N. ^{[1
,2
]}

Fischer-Betz, R. ^{[2
,3
]}

机构：

[1] Univ Klinikum, Med Klin & Poliklin 3, Dresden, Germany

[2] Tech Univ Dresden, Med Fak Carl Gustav Carus, Fetscherstr 74, D-01307 Dresden, Germany

[3] Heinrich Heine Univ Dusseldorf, Poliklin Rheumatol, Dusseldorf, Germany

[4] Univ Klinikum, Med Klin & Poliklin 3, Bereich Rheumatol, Fetscherstr 74, D-01307 Dusseldorf, Germany

来源：

ZEITSCHRIFT FUR RHEUMATOLOGIE | 2017年 / 76卷 / 01期

关键词：

Remission; Flares; Glucocorticoids; Immunosuppression; Antimalarials; MYCOPHENOLATE-MOFETIL; PULSE CYCLOPHOSPHAMIDE; RHEUMATOID-ARTHRITIS; INDUCTION TREATMENT; RISK; SAFETY; HYDROXYCHLOROQUINE; RECOMMENDATIONS; RITUXIMAB; GLUCOCORTICOIDS;

D O I：

10.1007/s00393-016-0258-0

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Similar to patients with other rheumatic diseases, patients with systemic lupus erythematosus (SLE) nowadays can also have the desire to terminate immunosuppressive and immunomodulatory medications. In order to provide appropriate advice to patients, the two main issues are the risk of severe adverse events under long-term therapy with any drug and the perceived risk of a flare, in particular of severe flares. The risks of long-term therapy vary greatly between drugs, ranging from severe unacceptable risks with cyclophosphamide and higher dose glucocorticoids to low risks usually outweighed by long-term benefits with hydroxychloroquine. The individual risk of flares is often difficult to estimate but clinical remission and at least 3 years of immunosuppression are recommended for lupus nephritis. The duration of remission can also be shorter in cases of milder forms of disease. This review article tries to put the available evidence into a clinical perspective and to derive concrete recommendations.

引用

页码：27 / +

页数：5

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