2024年美国风湿病学会（ACR）狼疮肾炎的筛查、治疗和管理指南。

IF 3.7 2区医学 Q1 RHEUMATOLOGY

Arthritis Care & Research Pub Date : 2025-03-24 DOI:10.1002/acr.25528

Lisa R Sammaritano, Anca Askanase, Bonnie L Bermas, Maria Dall'Era, Alí Duarte-García, Linda T Hiraki, Brad Rovin, Mary Beth F Son, Anthony Alvarado, Cynthia Aranow, April Barnado, Anna Broder, Hermine I Brunner, Vaidehi Chowdhary, Gabriel Contreras, Christele Felix, Elizabeth D Ferucci, Keisha L Gibson, Aimee O Hersh, Peter M Izmirly, Kenneth Kalunian, Diane Kamen, Brandi Rollins, Benjamin J Smith, Asha Thomas, Homa Timlin, Daniel J Wallace, Michael Ward, Muayad Azzam, Christie M Bartels, Joanne S Cunha, Kimberly DeQuattro, Andrea Fava, Gabriel Figueroa-Parra, Shivani Garg, Jessica Greco, Maria C Cuéllar-Gutiérrez, Priyanka Iyer, Andrew S Johannemann, April Jorge, Shanthini Kasturi, Hassan Kawtharany, Jana Khawandi, Kyriakos A Kirou, Alexandra Legge, Kelly V Liang, Megan M Lockwood, Alain Sanchez-Rodriguez, Marat Turgunbaev, Jessica N Williams, Amy S Turner, Reem A Mustafa

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引用次数: 0

摘要

目的：目的是为狼疮性肾炎的筛查、治疗和管理提供循证和专家指导。方法：核心小组开发了使用PICO格式（人群、干预、比较物和结果）筛选、治疗和管理狼疮性肾炎的临床问题。针对每个PICO问题完成了系统的文献综述，并采用分级建议评估、发展和评价（GRADE）方法评估证据质量并制定建议。投票小组就每项建议的方向（支持或反对）和力度（强烈或有条件）达成≥70%的共识。结果：我们提出了28个分级建议（7个强烈建议，21个有条件建议）和13个未分级的、基于共识的良好实践声明，用于狼疮性肾炎的筛查和管理。我们的建议集中在狼疮肾炎治疗是持续和持续的统一原则，而不是由离散的诱导/初始和维持/后续治疗组成。治疗应包括脉冲糖皮质激素，随后口服糖皮质激素逐渐减少，并对达到完全肾反应（CRR）的患者使用两种额外的免疫抑制剂，持续3-5年。结论：本指南为临床医生对狼疮性肾炎的筛查和治疗决策提供了指导。这些建议不应用于限制或拒绝获得治疗，因为治疗决定可能因每个患者独特的临床情况和个人偏好而有所不同。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

2024 American College of Rheumatology (ACR) Guideline for the Screening, Treatment, and Management of Lupus Nephritis.

The accepted version of this article was posted prematurely on March 24, 2025. The final version of record will be made fully available at a later date.

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来源期刊

Arthritis Care & Research RHEUMATOLOGY-

CiteScore

9.40

自引率

6.40%

发文量

368

审稿时长

3-6 weeks

期刊介绍： Arthritis Care & Research, an official journal of the American College of Rheumatology and the Association of Rheumatology Health Professionals (a division of the College), is a peer-reviewed publication that publishes original research, review articles, and editorials that promote excellence in the clinical practice of rheumatology. Relevant to the care of individuals with rheumatic diseases, major topics are evidence-based practice studies, clinical problems, practice guidelines, educational, social, and public health issues, health economics, health care policy, and future trends in rheumatology practice.