臨床検査60巻7号

2016年07月発行

今月の特集1 The SLE

SLE診療の変遷

著者： 北田彩子¹ 岡田正人¹

所属機関： ¹聖路加国際病院リウマチ膠原病センター

ページ範囲：P.698 - P.702

Point

●全身性エリテマトーデス（SLE）は免疫複合体の沈着によって全身のあらゆる臓器に多彩な症状を呈しうる．

●あくまで分類基準は臨床研究のためのものであり，診断は臨床的に行う．

●個々の標的臓器を定めて治療を行う．

●2015年に，わが国でもヒドロキシクロロキンが承認された．

参考文献

1）Pons-Estel BA, Catoggio LJ, Cardiel MH, et al：The GLADEL multinational Latin American prospective inception cohort of 1,214 patients with systemic lupus erythematosus: ethnic and disease heterogeneity among “Hispanics”. Medicine (Baltimore)　83：1-17，2004

2）Font J, Cervera R, Ramos-Casals M, et al：Clusters of clinical and immunologic features in systemic lupus erythematosus: analysis of 600 patients from a single center. Semin Arthritis Rheum　33：217-230，2004

3）Cervera R, Khamashta MA, Font J, et al：Systemic lupus erythematosus: clinical and immunologic patterns of disease expression in a cohort of 1,000 patients. The European Working Party on Systemic Lupus Erythematosus. Medicine (Baltimore)　72：113-124，1993

4）Hochberg MC：Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum　40：1725，1997

5）Petri M, Orbai AM, Alarcón GS, et al：Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum　64：2677-2686，2012

6）WALLACE, Daniel；HAHN：Bevra Hannahs. Dubois' Lupus Erythematosus and Related Syndromes: Expert Consult-Online. Elsevier Health Sciences，2012

7）Bertsias G, Ioannidis JP, Boletis J, et al：EULAR recommendations for the management of systemic lupus erythematosus. Report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics. Ann Rheum Dis　67：195-205，2008

8）Ruiz-Irastorza G, Ramos-Casals M, Brito-Zeron P, et al：Clinical efficacy and side effects of antimalarials in systemic lupus erythematosus: a systematic review. Ann Rheum Dis　69：20-28，2010

9）Xiong W, Lahita RG：Pragmatic approaches to therapy for systemic lupus erythematosus. Nat Rev Rheumatol　10：97-107，2014

10）古川福実，衛藤光，谷川瑛子，他：ヒドロキシクロロキン適正使用の手引き．日皮会誌　125：2049-2060，2015

11）Mak A, Cheak AA, Tan JY, et al：Mycophenolate mofetil is as efficacious as, but safer than, cyclophosphamide in the treatment of proliferative lupus nephritis: a meta-analysis and meta-regression. Rheumatology (Oxford)　48：944-952，2009

12）Kamanamool N, McEvoy M, Attia J, et al：Efficacy and adverse events of mycophenolate mofetil versus cyclophosphamide for induction therapy of lupus nephritis: systematic review and meta-analysis. Medicine (Baltimore)　89：227-235，2010

13）Hahn BH, McMahon MA, Wilkinson A, et al：American College of Rheumatology guidelines for screening, treatment, and management of lupus nephritis. Arthritis Care Res (Hoboken)　64：797-808，2012

14）Dooley MA, Jayne D, Ginzler EM, et al：Mycophenolate versus azathioprine as maintenance therapy for lupus nephritis. N Engl J Med　365：1886-1895，2011

15）Liu Z, Zhang H, Liu Z, et al：Multitarget therapy for induction treatment of lupus nephritis: a randomized trial. Ann Intern Med　162：18-26，2015

16）松下貴史，佐藤伸一：自己免疫性疾患の病態形成に関わる細胞・分子と臨床応用BAFFと自己免疫性疾患．日臨免疫会誌　28：333-342，2005

17）Vadacca M, Margiotta D, Sambataro D, et al：BAFF/APRIL pathway in Sjögren syndrome and systemic lupus erythematosus: relationship with chronic inflammation and disease activity. Reumatismo　62：259-265，2010

18）Navarra SV, Guzmán RM, Gallacher AE, et al：Efficacy and safety of belimumab in patients with active systemic lupus erythematosus: a randomised, placebo-controlled, phase 3 trial. Lancet　377：721-731，2011

19）Furie R, Petri M, Zamani O, et al：A phase III, randomized, placebo-controlled study of belimumab, a monoclonal antibody that inhibits B lymphocyte stimulator, in patients with systemic lupus erythematosus. Arthritis Rheum　63：3918-3930，2011

20）Terrier B, Amoura Z, Ravaud P, et al：Safety and efficacy of rituximab in systemic lupus erythematosus: results from 136 patients from the French AutoImmunity and Rituximab registry. Arthritis Rheum　62：2458-2466，2010

21）Merrill J, Buyon J, Furie R, et al：Assessment of flares in lupus patients enrolled in a phase II/III study of rituximab (EXPLORER). Lupus　20：709-716，2011

22）Furie R, Rovin R, Latnis KM, et al：Efficacy and safety of rituximab in subjects with active proliferative lupus nephritis (LN): results from the randomized, double-blind phase III LUNAR study. Arthritis Rheum　60（Suppl. 1）：S429，2009