Lupus Science and Medicine (Dec 2022)
Comparison of short interval and low dose (SILD) with high dose of cyclophosphamide in the susceptibility to infection in SLE: a multicentrereal-world study
- Lei Zhang,
- Xia Zhang,
- Hong Zhu,
- Zhanguo Li,
- Jing He,
- Yan Du,
- Xuewu Zhang,
- Jian Xu,
- Fei Wang,
- Jie Wu,
- Qing Zhao,
- Shuang Liu,
- Miao Shao,
- Miao Miao,
- Xiaoying Zhang,
- Xiaoping Zhang,
- Jin Lin,
- Zhibin Chen,
- Shengyun Liu,
- Xiao Wu,
- Ru Li,
- Lianjie Shi,
- Hongjiang Liu,
- Yao Chen,
- Feng Yu,
- Qingwen Wang,
- Liyun Zhang,
- Li Long,
- Honglian Yu,
- Yuan An,
- Huifang Guo,
- Lingyan Lei,
- Yanjie Ding,
- Rui Wu,
- Yucui Li,
- Huali Miao,
- Ruiying Jiao,
- Lixia Pang,
- Xueming Yao,
- Xiaofei Shi,
- Luping Cui,
- Fuai Lu,
- Kangkai Luo,
- Simeng Zhao,
- Yongfu Wang,
- Shulin Song,
- Xiaoyuan Zhou,
- Shumei Shi,
- Ruiyun Yu,
- Wenqiang Fan
Affiliations
- Lei Zhang
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Xia Zhang
- Department of Rheumatology and Immunology, Peking University People`s Hospital, Beijing, China
- Hong Zhu
- West China School of Nursing, Sichuan University/Nursing Department, Sichuan University West China Hospital, Chengdu, Sichuan, China
- Zhanguo Li
- Department of Rheumatology and Immunology, Peking University People`s Hospital, Beijing, China
- Jing He
- 1 Department of Rheumatology and Immunology, Peking University People`s Hospital, Beijing, China
- Yan Du
- Department of Rheumatology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Xuewu Zhang
- Department of Rheumatology, Peking University People’s Hospital, Beijing, China
- Jian Xu
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- Fei Wang
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, Henan, China
- Jie Wu
- Department of Anesthesiology, Xuanwu Hospital Capital Medical University, Beijing, China
- Qing Zhao
- Department of Cardiovascular Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
- Shuang Liu
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- Miao Shao
- Department of Rheumatology and Immunology, Peking University People`s Hospital, Beijing, China
- Miao Miao
- Affliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- Xiaoying Zhang
- Department of Rheumatology and Immunology, Peking University People`s Hospital, Beijing, China
- Xiaoping Zhang
- Department of Nephrology and Rheumatology, The PLA 960 Hospital, Jinan, Shandong, China
- Jin Lin
- Department of Rheumatology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Zhibin Chen
- Department of Nephrology, The Affiliated Yueqing Hospital of Wenzhou Medical University, Yueqing, Zhejiang, China
- Shengyun Liu
- First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Xiao Wu
- Department of Biostatistics, Harvard University T H Chan School of Public Health, Boston, MA, USA
- Ru Li
- Department of Rheumatology and Immunology, Peking University People`s Hospital, Beijing, China
- Lianjie Shi
- Department of Rheumatology and Immunology, Peking University International Hospital, Beijing, China
- Hongjiang Liu
- Department of Rheumatology and Immunology, The First People`s Hospital of Yichang, Yichang, Hubei, China
- Yao Chen
- Department of Hematology and Rheumatology, Wu zhong People`s Hospital, Wuzhong, Ningxia, China
- Feng Yu
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China
- Qingwen Wang
- Department of Rheumatology and Immunology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
- Liyun Zhang
- Department of Rheumatology and Immunology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan, Shanxi, China
- Li Long
- Department of Rheumatology and Immunology, Sichuan Provincial People`s Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
- Honglian Yu
- Department of Rheumatology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
- Yuan An
- Department of Rheumatology and Immunology, Peking University People`s Hospital, Beijing, China
- Huifang Guo
- Department of Rheumatology and Immunology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
- Lingyan Lei
- Department of Rheumatology and Immunology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
- Yanjie Ding
- Department of Rheumatology and Immunology, Huaihe Hospital of Henan University, Kaifeng, Henan, China
- Rui Wu
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Yucui Li
- Department of Rheumatology and Immunology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan, Shanxi, China
- Huali Miao
- Department of Rheumatology and Immunology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan, Shanxi, China
- Ruiying Jiao
- Department of Rheumatology and Immunology, Hulunbuir People`s Hospital, Hulunbuir, Inner Mongolia, China
- Lixia Pang
- Department of Rheumatology and Immunology, Hulunbuir People`s Hospital, Hulunbuir, Inner Mongolia, China
- Xueming Yao
- Department of Rheumatology and Immunology, The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China
- Xiaofei Shi
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, Henan, China
- Luping Cui
- Department of Rheumatology, Shanxi Provincial People’s Hospital, Taiyuan, Shanxi, China
- Fuai Lu
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, China
- Kangkai Luo
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, China
- Simeng Zhao
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, China
- Yongfu Wang
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, China
- Shulin Song
- Department of Rheumatology and Immunology, The First People`s Hospital of Yichang, Yichang, Hubei, China
- Xiaoyuan Zhou
- Department of Nephrology and Rheumatology, Zunyi Medical University Hospital, Zunyi, Guizhou, China
- Shumei Shi
- Department of Nephrology and Rheumatology, The PLA 960 Hospital, Jinan, Shandong, China
- Ruiyun Yu
- Department of Rheumatology and Immunology, Xinxiang Central Hospital, Xinxiang, Henan, China
- Wenqiang Fan
- Department of Rheumatology and Immunology, Xinxiang Central Hospital, Xinxiang, Henan, China
- DOI
- https://doi.org/10.1136/lupus-2022-000779
- Journal volume & issue
-
Vol. 9,
no. 1
Abstract
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/m2 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.
