系统性红斑狼疮疾病治疗在新兴市场的定义和应用:德尔菲专家组共识建议。

IF 1.9 4区 医学 Q3 RHEUMATOLOGY
Lupus Pub Date : 2025-06-06 DOI:10.1177/09612033251347341
Guillermo J Pons-Estel, Odirlei Andre Monticielo, Edgard Torres Dos Reis Neto, Juan Manuel Mejia-Vilet, Ibrahim Al-Homood, Reem Al-Jayyousi, Luciana Parente Costa Seguro, Suzan M Attar, Mercedes A García, Alejandra Babini, Ibrahim A Almaghlouth, Marina Scolnik, Sebastián Juan Magri, Emily Figueiredo Neves Yuki, Gabriel Teixeira Montezuma Sales, Gabriel Medrano-Ramirez, Alhussain Asiri, Humeira Badsha, Faisal Elbadawi, Humaid A Al Wahshi, Zeyad Alzahrani, Saadeya Abdulkarim, Razia Hussain, Bruno Rocha, Raef Gouhar, Munther Khamashta
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引用次数: 0

摘要

目的更好地了解于2022年首次提出的系统性红斑狼疮(SLE)和狼疮肾炎(LN)疾病改变框架在海湾地区和拉丁美洲专家中的接受程度和潜在应用。方法对一组SLE专家医师进行两次横断面德尔菲调查,并在两次调查之间举行研讨会讨论。调查包括多项选择和开放式回答问题。来自阿根廷、巴林、巴西、墨西哥、阿曼、沙特阿拉伯和阿拉伯联合酋长国的专家根据他们在SLE方面的专业知识被选中。在调查回应中,专家们达成了75%的共识。海湾地区和拉丁美洲地区还对共识进行了评估,以确定任何区域差异。结果所有被调查者对疾病改变的概念和组成部分的回答都是一致的,但存在一些较小的区域差异。专家一致认为,早期诊断,早期转诊到狼疮专家和多学科方法是实现疾病改善和更好的患者预后的关键因素。在目前的临床实践中,已发表的SLE/LN疾病改变定义的各个方面要么是“常规”(31%),要么是“有时”(62%)进行评估。达成的共识是,生物标志物是评估疾病改变的关键组成部分(91%),但目前可用的生物标志物是次优的(96%)。一致认为免疫抑制剂(96%)、生物制剂(92%)和羟氯喹(88%)是改善疾病的治疗方法。来自海湾地区的专家,而不是拉丁美洲的专家,一致认为糖皮质激素不能改善疾病。来自海湾和拉丁美洲的专家一致认为,疾病改良的概念可以为临床医生提供一个有价值的框架,以支持SLE和LN患者的管理。专家们强调,临床医生需要明确的指导,以便将疾病改变框架应用于他们的日常实践,以及不同的地方卫生保健系统。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Definition and application of systemic lupus erythematosus disease modification in emerging markets: Delphi panel consensus recommendations.

ObjectiveTo better understand the acceptance and potential application of the systemic lupus erythematosus (SLE) and lupus nephritis (LN) disease modification framework, which was first proposed in 2022, among experts in the Gulf region and Latin America.MethodsTwo cross-sectional Delphi surveys of a panel of expert SLE physicians were conducted, with a workshop discussion held between the two surveys. Surveys comprised multiple choice and open-response questions. Experts from Argentina, Bahrain, Brazil, Mexico, Oman, Saudi Arabia and United Arab Emirates were selected based on their demonstrated expertise in SLE. Consensus was indicated by >75% agreement among experts in survey responses. Consensus was also evaluated by Gulf and Latin American regions to identify any regional differences.ResultsThere was consensus across all the queried statements on the concept and components of disease modification, with some minor regional differences observed. Experts unanimously agreed that early diagnosis, early referral to a lupus specialist and a multidisciplinary approach are key factors for achieving disease modification and better patient outcomes. Aspects of the published SLE/LN disease modification definition were either 'routinely' (31%) or 'sometimes' (62%) assessed in current clinical practice. A consensus was reached that biomarkers are a key component of evaluating disease modification (91%), but that currently available biomarkers are sub-optimal (96%). There was consensus that immunosuppressants (96%), biologics (92%) and hydroxychloroquine (88%) are disease modifying treatments. Experts from the Gulf, but not Latin America, agreed that glucocorticoids are not disease modifying.ConclusionsThere was strong consensus across experts from the Gulf and Latin America that the concept of disease modification can provide a valuable framework to support clinicians for the management of patients with SLE and LN. Experts emphasised that clear guidance is required for clinicians to apply the disease modification framework to their routine practice, and in varying local healthcare systems.

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来源期刊
Lupus
Lupus 医学-风湿病学
CiteScore
4.20
自引率
11.50%
发文量
225
审稿时长
1 months
期刊介绍: The only fully peer reviewed international journal devoted exclusively to lupus (and related disease) research. Lupus includes the most promising new clinical and laboratory-based studies from leading specialists in all lupus-related disciplines. Invaluable reading, with extended coverage, lupus-related disciplines include: Rheumatology, Dermatology, Immunology, Obstetrics, Psychiatry and Cardiovascular Research…
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