ABSTRACT

Introduction: Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder, characterized by a relapsing and remitting pattern of disease activity in majority of the patients. Areas covered: This narrative review provides an overview of flare definition, major flare mimics, and the burden of flares in SLE. The authors highlight epidemiology and disease-related risk factor for flares and discuss strategies to reduce flares in SLE. Articles were selected from Pubmed searches conducted between June 2020 and September 2020. Expert opinion: Prolonged clinical remission is observed in approximately 20% of SLE patients flare over the course of the disease. Studies have shown that low disease activity is a good target in SLE, with similar risk of flares, mortality, and quality of life when compared to patients in remission. Clinical and immunological features have shown inconsistent results to identify patients at risk of flares in different cohorts. Cytokine, in serum and urine, has shown promising results to predict flares. However to be useful in clinical practice, they have to be simple, easy, and cost-effective. Future efforts in this direction will allow a more personalized treatment plan for SLE patients, reducing the burden associated with flares.

摘要

简介: 系统性红斑狼疮 (SLE) 是一种慢性自身免疫性疾病，其特征是大多数患者的疾病活动性复发和缓解。涵盖的领域：这篇叙述性评论概述了耀斑的定义、主要的耀斑模拟以及 SLE 中耀斑的负担。作者强调了突发的流行病学和疾病相关风险因素，并讨论了减少 SLE 突发的策略。文章选自 2020 年 6 月至 2020 年 9 月期间进行的 Pubmed 搜索。专家意见：大约 20% 的 SLE 患者在疾病过程中会出现长期的临床缓解。研究表明，低疾病活动度是 SLE 的一个很好的目标，与缓解期患者相比，具有相似的复发风险、死亡率和生活质量。临床和免疫学特征显示出不一致的结果来识别不同队列中存在突发风险的患者。血清和尿液中的细胞因子已显示出预测耀斑的有希望的结果。然而，为了在临床实践中有用，它们必须简单、容易且具有成本效益。未来在这个方向上的努力将为 SLE 患者提供更加个性化的治疗计划，减少与突发相关的负担。