Respuesta a la terapia inmunosupresora de rescate con rituximab en pacientes con nefritis lúpica en la región Caribe Colombiana
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Fecha
2022
Autores
Mercado Del Vecchio, Giovanni Fabricio
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Ediciones Universidad Simón Bolivar
Facultad de Ciencias de la Salud
Facultad de Ciencias de la Salud
Resumen
Antecedentes: El Lupus Eritematoso Sistémico (LES), afecta prácticamente a todos los aparatos y sistemas del cuerpo humano; sin embargo, las manifestaciones cutáneas son las más comunes (90%) y la afección renal (NL) le confiere un pronóstico especial. En este sentido la NL es una complicación frecuente en esta enfermedad, con una importante influencia en el pronóstico de la misma aumentando la morbimortalidad de los pacientes que la padecen.
Objetivo: Describir la respuesta a la terapia inmunosupresora de rescate con Rituximab en pacientes con nefritis lúpica en la Región Caribe Colombiana.
Metodología: Se presenta un tipo de estudio retrospectivo con una profundidad descriptiva y una finalidad aplicada con un carácter de medida cuantitativo esta investigación fue la ciudad de Barranquilla (ATL, CO). La población estuvo constituida por los pacientes registrados en Clinical Report File (CRF) de la Clínica donde se realizó la investigación, durante el periodo 2020 y 2021. Se diseñaron tablas y gráficos descriptivos para cada una de las variables, se efecto comparaciones aquellas que fueran pertinente a través de un Test de χ². Los datos fueron registrados en Excel y analizado con Statgraphic®.
Resultados: Se evaluaron un total de 18 pacientes que no respondieron a la terapia estándar de inducción con MCF o/y CFZ. En cuanto a la representación por genero las mujeres fueron mayoría. La edad mínima registrada fue de 22 años y la máxima de 53 años, la de los hombres fue mínima de 41 a una máxima de 43 años. Al comparar las edades entre los sexos, no se encontró una diferencia estadísticamente significativa con una confianza del 95% (W: 8.0; p-valor: 0,4434). De los pacientes que no tuvieron respuesta, el esquema que presento mayor tasa de no respuesta fue el de CFZ con un 67%, mientras que el MFC tuvo una tasa de 67. En cuanto, a la tasa de repuesta, el 47% No tuvieron una respuesta clínica el 47% pacientes, una respuesta parcial el 33% y solo el 20% una respuesta completa.
Conclusión: La respuesta a la terapia de rescate es independiente al sexo, así como la tasa de respuesta completa con terapia de rescate con Rituximab es baja y que aquellos pacientes que respondieron a la terapia de rescate recuperaron medianamente su TFG, por lo tanto, hay que seguir haciendo controles más cercanos para establecer mejor su.
Background: Systemic Lupus Erythematosus (SLE), affects practically all the apparatus and systems of the human body; however, skin manifestations are the most common (90%) and kidney disease (LN) confers a special prognosis. In this sense, LN is a frequent complication in this disease, with an important influence on its prognosis, increasing the morbidity and mortality of patients who suffer from it. Objective: To describe the response to rescue immunosuppressive therapy with Rituximab in patients with lupus nephritis in the Colombian Caribbean Region. Methodology: A type of retrospective study is presented with a descriptive depth and an applied purpose with a quantitative measurement character. This research was the city of Barranquilla (ATL, CO). The population consisted of the patients registered in the Clinical Report File (CRF) of the Clinic where the investigation was carried out, during the period 2020 and 2021. Descriptive tables and graphs were designed for each of the variables, comparisons were made for those that were relevant through a χ² Test. The data was recorded in Excel and analyzed with Statgraphic®. Results: A total of 18 patients who did not respond to standard induction therapy with MCF and/or CFZ were evaluated. Regarding representation by gender, women were the majority. The minimum age recorded was 22 years and the maximum was 53 years; that of men was a minimum of 41 to a maximum of 43 years. When comparing the ages between the sexes, no statistically significant difference was found with 95% confidence (W: 8.0; p-value: 0.4434). Of the patients who did not have a response, the regimen that presented the highest rate of non-response was the CFZ with 67%, while the MFC had a rate of 67. As for the response rate, 47% did not have a clinical response 47% patients, a partial response 33% and only 20% a complete response. Conclusion: The response to rescue therapy is independent of gender, as well as the rate of complete response with rescue therapy with Rituximab is low and that those patients who responded to rescue therapy moderately recovered their GFR, therefore, it is necessary to continue making closer checks to better establish your
Background: Systemic Lupus Erythematosus (SLE), affects practically all the apparatus and systems of the human body; however, skin manifestations are the most common (90%) and kidney disease (LN) confers a special prognosis. In this sense, LN is a frequent complication in this disease, with an important influence on its prognosis, increasing the morbidity and mortality of patients who suffer from it. Objective: To describe the response to rescue immunosuppressive therapy with Rituximab in patients with lupus nephritis in the Colombian Caribbean Region. Methodology: A type of retrospective study is presented with a descriptive depth and an applied purpose with a quantitative measurement character. This research was the city of Barranquilla (ATL, CO). The population consisted of the patients registered in the Clinical Report File (CRF) of the Clinic where the investigation was carried out, during the period 2020 and 2021. Descriptive tables and graphs were designed for each of the variables, comparisons were made for those that were relevant through a χ² Test. The data was recorded in Excel and analyzed with Statgraphic®. Results: A total of 18 patients who did not respond to standard induction therapy with MCF and/or CFZ were evaluated. Regarding representation by gender, women were the majority. The minimum age recorded was 22 years and the maximum was 53 years; that of men was a minimum of 41 to a maximum of 43 years. When comparing the ages between the sexes, no statistically significant difference was found with 95% confidence (W: 8.0; p-value: 0.4434). Of the patients who did not have a response, the regimen that presented the highest rate of non-response was the CFZ with 67%, while the MFC had a rate of 67. As for the response rate, 47% did not have a clinical response 47% patients, a partial response 33% and only 20% a complete response. Conclusion: The response to rescue therapy is independent of gender, as well as the rate of complete response with rescue therapy with Rituximab is low and that those patients who responded to rescue therapy moderately recovered their GFR, therefore, it is necessary to continue making closer checks to better establish your
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Palabras clave
Rituximab, Respuesta al tratamiento, Nefritis lúpica, Rituximab, Response to treatment, Lupus nephritis