Unmet medical needs in systemic lupus erythematosus.
Unmet medical needs in systemic lupus erythematosus.
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DOI：
10.1186/ar3919
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发表时间：
2012
影响因子：
4.9
通讯作者：
Petri M
中科院分区：
文献类型：
--
作者：
Lateef A;Petri M
系统性红斑狼疮 (SLE) 是一种具有多种表现形式的自身免疫性疾病，通常在 30 至 40 岁的年轻女性中发病。这种复发缓解性疾病的慢性性质导致随着时间的推移器官损伤逐渐加重。与一般人群相比，SLE 患者的死亡率和发病率有所增加。过去几十年的治疗进步显着改善了患者的治疗效果。五年生存率已从 20 世纪 50 年代的 50% 低点提高到 90% 以上。然而，SLE 患者管理的多个方面仍远未达到最佳状态。早期诊断仍然是一个挑战；诊断延误导致最终治疗延误的情况很常见。由于缺乏敏感的生物标志物，监测治疗仍然存在问题。目前的治疗方案严重依赖皮质类固醇，尽管众所周知皮质类固醇会导致器官损伤。肾炎、顽固性皮肤病变和神经系统受累等难治性疾病的治疗需要更有效的新方法。认知功能障碍在系统性红斑狼疮患者中很常见，但早期识别和充分治疗尚未建立。过早加速的动脉粥样硬化仍然是发病和死亡的主要原因。疲劳是最严重的致残症状之一，导致系统性红斑狼疮患者的生活质量下降。正在进行的 SLE 研究面临许多挑战，包括招募同质患者群体、使用可靠的结果测量和标准对照组。当前的审查将强调在这种复杂疾病的管理中一些尚未解决的突出挑战。
Systemic lupus erythematosus (SLE) is an autoimmune disease of diverse manifestations, with onset usually in young women in the third to fourth decade of life. The chronic nature of this relapsing remitting disease leads to organ damage accrual over time. Mortality and morbidity are increased in patients with SLE compared with the general population. Therapeutic advances over the last few decades have led to significant improvements in patient outcomes. Five-year survival has improved to over 90% from a low of 50% in the 1950s. However, multiple aspects of the management of SLE patients are still far from optimal. Early diagnosis remains a challenge; diagnostic delays leading to delay in definitive treatment are common. Monitoring treatment remains problematic due to the paucity of sensitive biomarkers. Current treatment regimens rely heavily on corticosteroids, even though corticosteroids are well known to cause organ damage. Treatment of refractory disease manifestations such as nephritis, recalcitrant cutaneous lesions and neurological involvement require new approaches with greater efficacy. Cognitive dysfunction is common in SLE patients, but early recognition and adequate treatment are yet to be established. Premature accelerated atherosclerosis remains a leading cause of morbidity and mortality. Fatigue is one of the most disabling symptoms, and contributes to the poor quality of life in patients with SLE. Ongoing research in SLE faces many challenges, including enrollment of homogeneous patient populations, use of reliable outcome measures and a standard control arm. The current review will highlight some of the outstanding unmet challenges in the management of this complex disease.
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影响因子：
6.1
作者：
Barr, RG;Seliger, S;Radhakrishnan, J
通讯作者：
Radhakrishnan, J
影响因子：
5.5
作者：
Croca, Sara C.;Rodrigues, Teresa;Isenberg, David A.
通讯作者：
Isenberg, David A.
影响因子：
5.5
作者：
Isenberg, David;Appel, Gerald B.;Solomons, Neil
通讯作者：
Solomons, Neil
影响因子：
5.5
作者：
Duran-Barragan, S.;McGwin, G., Jr.;Alarcon, G. S.
通讯作者：
Alarcon, G. S.
影响因子：
--
作者：
Bachen, Elizabeth A.;Chesney, Margaret A.;Criswell, Lindsey A.
通讯作者：
Criswell, Lindsey A.