[Synchronous intensive treatment for patients with systemic lupus erythematosus having poor life prognosis].
Synchronous intensive treatment (SIT) involving two-stage programmed use of pulse therapy (PT), plasmapharesis (P) or hemosorption with methylprednisolone and cyclophosphamide was performed in 56 patients with systemic lupus erythematosus (SLE). All the patients were found to have a combination of factors showing a poor life prognosis: the onset of SLE in adolescence or youth (52%), nephritis (70%), arterial hypertension (54%), cerebropathy (50%), generalized vasculitis (34%), cryoglobulinemia (66%). After a year therapy, remission and the minimum progression were observed in 19.6 and 53.6%, respectively. The highest effect of SIT was found in the patients with SLE of duration of under a year and with the highest progression. A long-term follow-up that lasted 78 +/- 24 months revealed persistent improvement, the minimum activity and remission in 71% of patients. The synchronous programmed use of P and PT produces a rapid and effective impact on clinical and laboratory manifestations and improves life prognosis in patients with SLE.
Solov'ev
S K
SK
Nasonov
V A
VA
D000293:Adolescent; D000328:Adult; D003422:Critical Care / Q000379:methods; D003520:Cyclophosphamide / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D006464:Hemoperfusion; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D010956:Plasmapheresis; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate