Comparison of short interval and low dose (SILD) with high dose of cyclophosphamide in the susceptibility to infection in SLE: a multicentrereal-world study

OBJECTIVE: Infection is a major cause of death in patients with SLE. This study aimed to explore the infection rate in patients with SLE receiving a low dose of intravenous cyclophosphamide (IV-CYC). METHODS: Clinical parameters of 1022 patients with SLE from 24 hospitals in China were collected. Pa...

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Detalles Bibliográficos
Autores principales: Shao, Miao, Miao, Miao, Zhang, Xia, Zhang, Xiaoying, An, Yuan, Guo, Huifang, Lei, Lingyan, Zhao, Qing, Ding, Yanjie, Lin, Jin, Wu, Rui, Yu, Feng, Li, Yucui, Miao, Huali, Zhang, Liyun, Du, Yan, Jiao, Ruiying, Pang, Lixia, Long, Li, Yao, Xueming, Shi, Xiaofei, Wang, Fei, Cui, Luping, Zhang, Lei, Liu, Shengyun, Lu, Fuai, Luo, Kangkai, Zhao, Simeng, Wang, Yongfu, Wu, Xiao, Wang, Qingwen, Liu, Hongjiang, Song, Shulin, Zhou, Xiaoyuan, Zhang, Xiaoping, Shi, Shumei, Zhu, Hong, Chen, Yao, Yu, Honglian, Wu, Jie, Yu, Ruiyun, Fan, Wenqiang, Liu, Shuang, Xu, Jian, Chen, Zhibin, Shi, Lianjie, He, Jing, Zhang, Xuewu, Li, Zhanguo, Li, Ru
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Immunology and Inflammation
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9644361/
https://www.ncbi.nlm.nih.gov/pubmed/36351697
http://dx.doi.org/10.1136/lupus-2022-000779
Descripción
Sumario:OBJECTIVE: Infection is a major cause of death in patients with SLE. This study aimed to explore the infection rate in patients with SLE receiving a low dose of intravenous cyclophosphamide (IV-CYC). METHODS: Clinical parameters of 1022 patients with SLE from 24 hospitals in China were collected. Patients were divided into the short-interval and lower-dose (SILD, 400 mg every 2 weeks) IV-CYC group and the high-dose (HD, 500 mg/m(2) of body surface area every month) IV-CYC group. The clinical data and infection rate between the two groups were compared. RESULTS: Compared with HD IV-CYC, the infection rate of the SILD IV-CYC group was significantly lower (13.04% vs 22.27%, p=0.001). Respiratory tract infection (10.28% vs 15.23%, p=0.046) and skin/soft tissue infection (1.78% vs 4.3%, p=0.040) were significantly decreased in the SILD IV-CYC group. Moreover, infections occurred most likely in patients with SLE with leucopenia (OR 2.266, 95% CI 1.322 to 3.887, p=0.003), pulmonary arterial hypertension (OR 2.756, 95% CI 1.249 to 6.080, p=0.012) and >15 mg/day of glucocorticoid (OR 2.220, 95% CI 1.097 to 4.489, p=0.027). CONCLUSIONS: SILD IV-CYC showed a lower frequency of infection events than high-dose IV-CYC in patients with SLE.

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