Ausschleichen und Beenden von immunsuppressiven Therapien
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- 作者：Prof. Dr. M. Aringer ; N. Leuchten ; R. Fischer-Betz
- 关键词：SchlüsselwörterRemission ; Schübe ; Glukokortikoide ; Immunsuppressiva ; Antimalariamittel
- 刊名：Zeitschrift für Rheumatologie
- 出版年：2017
- 出版时间：February 2017
- 年：2017
- 卷：76
- 期：1
- 页码：27-32
- 全文大小：
- 刊物主题：Internal Medicine; Rheumatology;
- 出版者：Springer Medizin
- ISSN：1435-1250
- 卷排序：76
文摘
Similar to patients with other rheumatic diseases, patients with systemic lupus erythematosus (SLE) nowadays can also have the desire to terminate immunosuppressive and immunomodulatory medications. In order to provide appropriate advice to patients, the two main issues are the risk of severe adverse events under long-term therapy with any drug and the perceived risk of a flare, in particular of severe flares. The risks of long-term therapy vary greatly between drugs, ranging from severe unacceptable risks with cyclophosphamide and higher dose glucocorticoids to low risks usually outweighed by long-term benefits with hydroxychloroquine. The individual risk of flares is often difficult to estimate but clinical remission and at least 3 years of immunosuppression are recommended for lupus nephritis. The duration of remission can also be shorter in cases of milder forms of disease. This review article tries to put the available evidence into a clinical perspective and to derive concrete recommendations.