■难治性狼疮性肾炎(LN)的状况会对患者的预后和预期寿命产生负面影响,对临床管理构成挑战。这项介入研究评估了来氟米特对难治性LN患者的疗效和安全性。
■20例难治性LN患者纳入本研究。每天口服20-40mg来氟米特。同时,免疫抑制剂被撤回,皮质类固醇逐渐减少。大多数患者的平均随访时间为3、6和12个月,而有些患者的随访时间长达24个月。我们记录生化参数和副作用。我们使用意向治疗分析计算了应答率。
■18名患者(90%)完成了研究。3个月时,80%(16/20)的患者24小时尿蛋白量减少了25%以上。6个月时,三名患者(15%)获得部分缓解,5名患者(25%)达到完全缓解。然而,到12个月和24个月,完全反应率下降到15%和20%,分别。客观反应为30%(6/20),40%(8/20),40%(8/20),在3、6、12和24个月时为30%(6/20),分别。两名患者因发展为血细胞减少症和白细胞减少症而退出研究。
■在诊断为难治性LN的患者中,我们的研究表明,来氟米特由于其缓解率和安全性,可能是一种有前景的治疗选择.
The condition of refractory lupus nephritis (LN) negatively affects the prognosis and life expectancy of the patients, posing a challenge to manage in clinical. This interventional
study evaluated the efficacy as well as safety of
leflunomide in patients with refractory LN.
Twenty patients with refractory LN were enrolled in this
study. A daily dose of 20-40 mg of
leflunomide was given to the patients orally. Meanwhile, immunosuppressives were withdrawn, and corticosteroids were gradually tapered. There was an average follow-up period of 3, 6, and 12 months for most patients while some were observed for as long as 24 months. We recorded biochemical parameters and side effects. We calculated the response rate using intention-to-treat analysis.
Eighteen patients (90%) completed the
study. At 3 months, 80% (16/20) of the patients achieved more than a 25% decrease in 24-hour urine protein quantity. At 6 months, three patients (15%) achieved a partial response, and five patients (25%) achieved a complete response. However, by 12 months and 24 months, the complete response rate dropped to 15% and 20%, respectively. The objective responses were 30% (6/20), 40% (8/20), 40% (8/20), and 30% (6/20) at 3, 6, 12, and 24 months, respectively. Two patients withdrew from the study due to developing cytopenia and leucopenia.
In patients diagnosed with refractory LN, our
study shows that
leflunomide could be a promising treatment option owing to its response rate and safety profile.