Cytotoxic immunosuppressants commonly used in the treatment of SLE

Systemic lupus erythematosus (SLE) is a group of highly heterogeneous diseases

Cytotoxic immunosuppressants used in the Department of Rheumatology and Immunology to treat SLE are mainly cyclophosphamide (CTX) and methotrexate (MTX

CTX 

1) CTX has a strong and lasting inhibitory effect on humoral immunity by inhibiting B cell proliferation and antibody production, and it has always maintained the most effective position in the treatment of rheumatism and cannot be shaken

For recurrent SLE, it can reverse or prevent the development of chronic lesions to a large extent and prevent chronic failure of organs

2) The most fatal side effects of CTX are bone marrow suppression and infection, which are mainly related to the single dose of CTX, the interval between shocks, and the patient's constitution and tolerability at that time, and are not related

3) The biggest advantage of IV-CTX is that it can flexibly grasp the dosage and interval between

It can be 200 mg once every other day, 400 mg or 600 mg once a week or once every other week, 800 mg to 1200 mg once every other week, once every 3 weeks, once every 4 weeks, once every 3 months, and so on

The dose density of IV-CTX is related to efficacy and also to recent adverse reactions, and under the premise of weighing good efficacy and safety, IV-CTX can be administered without a fixed dose and interval for experienced specialists

MTX

1) Many reports suggest that MTX can control arthritis, skin lesions, fever and serositis of SLE

2) MTX is less effective than CTX

3) Intrathecal injection of MTX can be used to treat acute meningal leukemia and SLE encephalitis

4) In fact, injectable MTX works better than oral MTX

5) A small number of patients have mild increased liver enzymes, usually recovering

Cytotoxic immunosuppressants act on the production and proliferation of primitive immune cells, are the source of immune inflammation, favor immune reconstitution, and are considered to be the two drugs

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