Сравнительная характеристика клинических проявлений и особенностей лечения системной красной волчанки, дебютировавшей до и после 18 лет

Abstract

Background: systemic lupus erythematosus (SLE) is characterized by a marked clinical polymorphism. It is aknowledged that juvenile systemic lupus erythematosus (SLE) differs from adult SLE by a more aggressive course and a greater drug load, which lead to the damage accumulation during the disease It is unknown to what extent these patterns are preserved during modern treatment methods administration in the population of the Russian Federation. Aim: to compare the clinical manifestations and treatment aspects of SLE in patients with disease onset before and after 18 years. Patients and Methods: demographic and clinical data of 82 patients observed in St. Petersburg Clinical Rheumatological Hospital No. 25 were studied. SLE course patterns and its treatment aspects, as well as the prevalence of adverse effects during corticosteroid (GCS) therapy in two cohorts of patients with SLE onset before and after 18 years were evaluated. Results: it was found that there were no significant differences in the clinical picture of SLE in patients with different age-related onset. Moreover, genetically engineered biological therapy (GEBT) is commonly used in jSLE (32% vs. 6.25%, p<0.05), while in active aSLE — higher doses of glucocorticoids (GCS): 27.8 mg vs. 14.65 mg per day (p<0.01). Commonly, there are complications during steroid therapy (e.g., hypertension). Over 96% of patients who have reached a low activity of SLE during GCS therapy continue to take GCS, regardless of the disease age-related onset. Conclusion: patients with juvenile and adult SLE onsets have comparable clinical disease activity, despite the fact that patients with jSLE receive more GEBT and less GCS therapy in the setting of disease activity. After reaching a low disease activity, over 96% of patients, regardless of the disease age-related onset, continue to receive GCS, which determines the development of complications and the need for further improvement of SLE treatment tactics. KEYWORDS: juvenile systemic lupus erythematosus, adult systemic lupus erythematosus, activity, clinical manifestations, glucocorticoids. FOR CITATION: Mazurov V.I., Aliyev D.B., Gaydukova I.Z., Inamova O.V. Comparative characteristics of clinical manifestations and treatment aspects of systemic lupus erythematosus onset before and after 18 years. Russian Medical Inquiry. 2022;6(8):464–469 (in Russ.). DOI: 10.32364/2587-6821-2022-6-8-464-469.