PDF(Pubmed)
Abstract：
UNASSIGNED: Data on non-infectious cryoglobulinemic vasculitis (NICV) is scarce, especially concerning the management of relapses, which are troublesome. We aimed to investigate risk factors for relapse in NICV.
UNASSIGNED: A systematic literature search of CINAHL, Embase, MEDLINE, Scopus, and the Web of Science databases was implemented until April 2023. Eligible studies included randomized control trials, observational studies, and case series with ≥4 patients. Two reviewers independently extracted data and assessed the quality of the eligible studies.
UNASSIGNED: A total of 3,724 articles were retrieved from a database search, with 27 studies meeting the inclusion criteria for review. Most studies (n = 23) detailed relapses, with the time to relapse varying between 1 and 80 months. The relapse rate was reported at 28% in Type I NICV and ranged from 22% to 60% in mixed NICV. Risk factors for relapse in NICV were identified based on the cryoglobulin subtype and correlated with clinical and immunological responses to varying treatment regimens. Type I NICV with an associated lymphoproliferative disorder exhibited a response-relapse pattern. Cutaneous and articular involvement and incomplete clinical and immunological responses to treatment, particularly corticosteroid monotherapy and occasionally rituximab, influence the risk of relapse in Type II and Type III NICV.
UNASSIGNED: Our findings underscore the significance of attaining both clinical and immunological responses and identifying risk factors for relapse in NICV. Appropriate risk stratification for NICV patients is essential for the successful implementation of effective treatment strategies.
UNASSIGNED: https://www.crd.york.ac.uk/prospero/, identifier CRD42023408140.
UNASSIGNED: A systematic literature search of CINAHL, Embase, MEDLINE, Scopus, and the Web of Science databases was implemented until April 2023. Eligible studies included randomized control trials, observational studies, and case series with ≥4 patients. Two reviewers independently extracted data and assessed the quality of the eligible studies.
UNASSIGNED: A total of 3,724 articles were retrieved from a database search, with 27 studies meeting the inclusion criteria for review. Most studies (n = 23) detailed relapses, with the time to relapse varying between 1 and 80 months. The relapse rate was reported at 28% in Type I NICV and ranged from 22% to 60% in mixed NICV. Risk factors for relapse in NICV were identified based on the cryoglobulin subtype and correlated with clinical and immunological responses to varying treatment regimens. Type I NICV with an associated lymphoproliferative disorder exhibited a response-relapse pattern. Cutaneous and articular involvement and incomplete clinical and immunological responses to treatment, particularly corticosteroid monotherapy and occasionally rituximab, influence the risk of relapse in Type II and Type III NICV.
UNASSIGNED: Our findings underscore the significance of attaining both clinical and immunological responses and identifying risk factors for relapse in NICV. Appropriate risk stratification for NICV patients is essential for the successful implementation of effective treatment strategies.
UNASSIGNED: https://www.crd.york.ac.uk/prospero/, identifier CRD42023408140.
摘要：
■非感染性冷球蛋白性血管炎（NICV）的数据很少，特别是关于复发的管理，这很麻烦。我们旨在调查NICV复发的危险因素。
■CINAHL系统文献检索，Embase,MEDLINE,Scopus,WebofScience数据库一直实施到2023年4月。符合条件的研究包括随机对照试验，观察性研究，以及≥4名患者的病例系列。两名评审员独立提取数据并评估合格研究的质量。
■从数据库搜索中总共检索到3,724篇文章，27项研究符合纳入标准进行审查。大多数研究（n=23）详细的复发，复发时间在1到80个月之间。据报道，I型NICV的复发率为28％，混合NICV的复发率为22％至60％。根据冷球蛋白亚型确定了NICV复发的危险因素，并与不同治疗方案的临床和免疫反应相关。具有相关淋巴增生性疾病的I型NICV表现出反应复发模式。皮肤和关节受累以及对治疗的临床和免疫反应不完全，特别是皮质类固醇单一疗法和偶尔利妥昔单抗，影响II型和III型NICV的复发风险。
■我们的研究结果强调了在NICV中获得临床和免疫反应以及确定复发危险因素的重要性。对NICV患者进行适当的风险分层对于成功实施有效的治疗策略至关重要。
■https://www.crd.约克。AC.英国/普华永道/，标识符CRD42023408140。
■CINAHL系统文献检索，Embase,MEDLINE,Scopus,WebofScience数据库一直实施到2023年4月。符合条件的研究包括随机对照试验，观察性研究，以及≥4名患者的病例系列。两名评审员独立提取数据并评估合格研究的质量。
■从数据库搜索中总共检索到3,724篇文章，27项研究符合纳入标准进行审查。大多数研究（n=23）详细的复发，复发时间在1到80个月之间。据报道，I型NICV的复发率为28％，混合NICV的复发率为22％至60％。根据冷球蛋白亚型确定了NICV复发的危险因素，并与不同治疗方案的临床和免疫反应相关。具有相关淋巴增生性疾病的I型NICV表现出反应复发模式。皮肤和关节受累以及对治疗的临床和免疫反应不完全，特别是皮质类固醇单一疗法和偶尔利妥昔单抗，影响II型和III型NICV的复发风险。
■我们的研究结果强调了在NICV中获得临床和免疫反应以及确定复发危险因素的重要性。对NICV患者进行适当的风险分层对于成功实施有效的治疗策略至关重要。
■https://www.crd.约克。AC.英国/普华永道/，标识符CRD42023408140。
