糖皮质激素停用对系统性红斑狼疮复发风险的影响：一项系统综述和荟萃分析

IF 4.6 2区综合性期刊 Q1 MULTIDISCIPLINARY SCIENCES

iScience Pub Date : 2025-06-12 DOI:10.1016/j.isci.2025.112875

Sicheng Huang , Yimeng Jia , Yuelun Zhang , Hongda Chen , Chuiwen Deng , Yunyun Fei

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引用次数: 0

摘要

停用糖皮质激素（GCs）是否会增加系统性红斑狼疮（SLE）的复发风险仍然是一个关键的考虑因素。对10项随机临床试验（rct）和观察性队列研究进行了系统回顾和荟萃分析，以评估GC停药与维持后的复发结果。随机对照试验显示，GC停药导致总体复发率升高(风险差[RD] 0.13；95% ci 0.03-0.23；p = 0.008)，严重复发率增加(RD为0.02；95% ci 0.00-0.05；P = 0.04)，而观察性队列发现停药和维持之间的复发率相似，并且在15%的范围内证明非劣效性。这些研究结果表明，SLE患者应谨慎停用GC，需要更多的研究来确定哪些患者可以安全地停用GC。这篇综述应该有助于指导维持治疗的选择，并强调个性化的逐渐减少策略的必要性，以优化SLE管理的长期结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Effects of glucocorticoid withdrawal on relapse risk in systemic lupus erythematosus: A systematic review and meta-analysis

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Effects of glucocorticoid withdrawal on relapse risk in systemic lupus erythematosus: A systematic review and meta-analysis

Whether discontinuing glucocorticoids (GCs) increases relapse risk in systemic lupus erythematosus (SLE) remains a critical consideration. A systematic review and meta-analysis of 10 randomized clinical trials (RCTs) and observational cohort studies was conducted to evaluate relapse outcomes after GC withdrawal versus maintenance. RCTs showed that GC withdrawal led to a higher overall relapse rate (risk difference [RD] 0.13; 95% CI 0.03–0.23; p = 0.008) and an increased rate of severe relapses (RD 0.02; 95% CI 0.00–0.05; p = 0.04), whereas observational cohorts found similar relapse rates between withdrawal and maintenance and demonstrated non-inferiority within a 15% margin. These findings indicate that GC withdrawal should be approached with caution in patients with SLE, and more research is needed to identify which patients can safely discontinue GC. This review should help guide the choice of maintenance therapy and highlights the need for personalized tapering strategies to optimize long-term outcomes in SLE management.

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来源期刊

iScience Multidisciplinary-Multidisciplinary

CiteScore

7.20

自引率

1.70%

发文量

1972

审稿时长

6 weeks

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