Patient preferences for treatment of lupus nephritis
Patient preferences for treatment of lupus nephritis
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DOI：
10.1002/art.10534
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发表时间：
2002-08-15
期刊：
影响因子：
--
通讯作者：
Concato, J
中科院分区：
文献类型：
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作者：
Fraenkel, L;Bogardus, S;Concato, J
客观的。旨在检查狼疮患者在选择环磷酰胺而非硫唑嘌呤治疗狼疮性肾炎之前所需的肾脏存活改善程度。方法。向患者提供环磷酰胺和硫唑嘌呤的描述，并要求患者指出如果每种药物都具有相同的肾脏存活概率，他们的首选选择。通过系统地增加毒性更大的治疗的肾脏存活概率直到受访者的选择改变来评估偏好的强度。结果。 93 名受过良好教育的女性（平均年龄 +/- SD 40 +/- 7 岁）参与了这项研究。当两种药物具有相同的肾脏存活概率时，百分之九十八 (91/93) 的参与者选择硫唑嘌呤而不是环磷酰胺。尽管大多数受试者为了更好的肾脏存活而转而使用环磷酰胺，但 31% (28/91) 的受试者不愿意为了改善短期肾脏存活而从硫唑嘌呤转为环磷酰胺，15% (14/91) 不愿意为了改善长期肾脏存活而从硫唑嘌呤转为环磷酰胺。结论。尽管大多数患者为了更好的肾存活而转而使用环磷酰胺，但仍有相当一部分患者不愿意接受与环磷酰胺相关的毒性，即使它在预防肾衰竭方面比硫唑嘌呤好得多。
Objective. To examine the amount of improvement in renal survival that lupus patients require before choosing cyclophosphamide over azathioprine for the treatment of lupus nephritis.Methods. Patients were presented with descriptions of cyclophosphamide and azathioprine and asked to indicate their preferred choice if each conferred an equal probability of renal survival. Strength of preference was assessed by systematically increasing the probability of renal survival of the more toxic treatment until the respondent's choice switched.Results. Ninety-three well-educated women (mean age +/- SD 40 +/- 7 years) participated in the study. Ninety-eight percent (91/93) of the participants chose azathioprine over cyclophosphamide when both drugs conferred an equal probability of renal survival. Although most subjects switched preferences to cyclophosphamide for better renal survival, 31% (28/91) were unwilling to switch from azathioprine to cyclophosphamide for improved short-term renal survival, and 15% (14/91) were unwilling to switch from azathioprine to cyclophosphamide for improved long-term renal survival.Conclusion. Although the majority of patients switched preferences to cyclophosphamide for better renal survival, a substantial minority was unwilling to accept the toxicity associated with cyclophosphamide, even if it was much better than azathioprine at preventing renal failure.