The effect of cyclophosphamide treatment on the prognosis of patients with systemic lupus erythematosus
10.3760/cma.j.issn.1007-7480.2019.08.002
- VernacularTitle:环磷酰胺对系统性红斑狼疮预后的影响
- Author:
Yuxuan CHEN
1
;
Xuebing FENG
;
Ziyi JIN
;
Dandan WANG
;
Lingyun SUN
Author Information
1. 南京大学医学院附属鼓楼医院风湿免疫科 210008
- Keywords:
Lupus erythematosus,systemic;
Cyclophosphamide;
Prognosis
- From:
Chinese Journal of Rheumatology
2019;23(8):507-512,后插1
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of cyclophosphamide (CTX) on the prognosis of different types of systemic lupus erythematosus (SLE).Methods A retrospective cohort study,in which 1 372 lupus patients were included,was conduted in 26 hospitals in Jiangsu province from 1999 to 2009.The data was analyzed by the chi-square test,Mann-Whitney U test,Kaplan-Meier survival analysis and Cox regression analysis.Results 1 372 SLE patients were followed up,in which 582 patients (42.4％) were treated with cycloph-osphamide and 790 patients (57.6％) were not.There were statistically significant differences in SLE disease activity index (SLEDAI) at admission and discharge between the two groups (t=3.398,P=0.001;t=5.044,P＜0.01).The survival rate was significantly higher in CTX treatment group compared to those without CTX administration (x2=4.667,P=0.031).Female (P=0.018,HR=0.68),disease duration ≤7 years (P=0.033,R=0.697),decreased levels of complement C3 (P=0.047,HR=0.7),and patients treated with cyclophosphamide and glucocorti-costeroid (P=0.047,HR=0.734) were predictors for good prognosis for CTX treatment.In patients with central nervous system (x2=6.611,P=0.010),heart and lung (x2=7.223,P=0.007) and renal system involvement (x2=5.217,P=0.022),there were statistically significant differences in survival rate and survival time between the CTX treated group and untreated group.Conclusion Cyclophosphamide treatment was beneficial for female SLE patients with low complement,short disease duration and important organ involvement such as heart,lung,kidney and central nervous system.
