Buscar en
Revista Colombiana de Reumatología (English Edition)
Toda la web
Inicio Revista Colombiana de Reumatología (English Edition) Pharmacological treatment of scleroderma renal crisis: A systematic literature r...
Journal Information
Vol. 27. Issue S1.
Systemic Sclerosis
Pages 111-125 (April 2020)
Share
Share
Download PDF
More article options
ePub
Visits
0
Vol. 27. Issue S1.
Systemic Sclerosis
Pages 111-125 (April 2020)
Review Article - Meta-analysis
DOI: 10.1016/j.rcreue.2020.01.003
Pharmacological treatment of scleroderma renal crisis: A systematic literature review
Tratamiento farmacologico de la crisis renal en esclerosis sistémica: una revisión sistemática de la literatura
Visits
...
Alejandra de Zubiría-Mariaa,b, Jorge Bruce Florez-Suarezb, Paul Mendez-Patarroyoa,b, Gerardo Quintana-Lopeza,b,c,
Corresponding author
g.quintana20@uniandes.edu.co

Corresponding author at: Rheumatology Section, Department of Internal Medicine, Fundación Santa Fe de Bogotá University Hospital, Carrera 7 No. 117-15, Postal Code 220246, Bogota D.C., Colombia.
a School of Medicine, Universidad de Los Andes, Carrera 1 No. 18 A-12, Postal Code 111711, Bogota D.C., Colombia
b REUMAVANCE Group, Section of Rheumatology, Department of Internal Medicine, Fundación Santa Fe de Bogota University Hospital, Carrera 7 No. 117-15, Postal Code 220246, Bogota D.C., Colombia
c School of Medicine, Universidad Nacional de Colombia, Carrera 30 # 45-03, Campus Universitario, Postal Code 111321, Bogota, Colombia
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (2)
Tables (4)
Table 1. Characteristics of the studies included in the review.
Table 2. Quality of evidence assessment of cohort studies using the SIGN checklist.
Table 3. Quality of evidence assessment of case-control studies using the SIGN checklist.
Table 4. Quality of evidence assessment of case series studies using the critical appraisal tool developed by the Joanna Briggs Institute from the University of Adelaide.
Show moreShow less
Additional material (1)
Abstract
Background

Scleroderma renal crisis is a condition that affects approximately 4–6% of patients with systemic sclerosis, especially with diffuse compromise. Clinical manifestations are variable, representing a diagnostic challenge.

Objective

The study aims to describe and analyze the different pharmacological treatments available for the management of scleroderma renal crisis.

Materials and methods

A systematic literature review was done based on observational studies and clinical trials about the treatment of scleroderma renal crisis, using monotherapy or combined therapy. The studies were identified using electronic scientific databases, including MEDLINE PUBMED and EMBASE, in English, published between January 1990 and August 2019.

Results

Eleven studies were included (ten observational studies and one open clinical trial). Of them, seven were cohorts, one case series, and two case–control studies. Overall, 1113 patients were included in the analyzed studies. All studies used angiotensin-converting enzyme inhibitors as exposition, case definition, and/or comparison in the clinical trial. Regarding the need for dialysis, approximately 53.9% of patients required it temporarily or permanently. Approximately 6–27% of patients required temporal dialysis, and 19–78% required permanent dialysis. One-year survival range was between 64 and 84%; two-year survival was between 53 and 74%; five-year survival between 40 and 90%, and finally ten–year survival between 35 and 47%.

Conclusions

Angiotensin-converting enzyme inhibitors continue to be the first line of treatment for scleroderma renal crisis by contributing to a decrease in short-term mortality. However, alternative therapeutic options are required as a high percentage of patients still require dialysis. Future clinical trials are necessary to assess the effectiveness and safety of different therapeutic options.

Keywords:
Scleroderma renal crisis
Systemic sclerosis
Hypertension
Acute renal failure
Angiotensin-converting enzyme inhibitors
Angiotensin receptor antagonists
Resumen
Introducción

La crisis renal es una condición que afecta aproximadamente a 4-6% de los pacientes con esclerosis sistémica, especialmente con compromiso difuso. Las manifestaciones clínicas son variables, representando un reto diagnóstico en la práctica clínica.

Objetivo

El objetivo del estudio fue describir y analizar los diferentes tratamientos farmacológicos disponibles para el manejo de la crisis renal en esclerosis sistémica.

Materiales y métodos

Una revisión sistemática de la literatura fue desarrollada con base en estudios observacionales y ensayos clínicos sobre el tratamiento de la crisis renal, utilizando monoterapia o terapias combinadas. Los estudios fueron identificados utilizando bases de datos científicas que incluyeron MEDLINE PUBMED y EMBASE, que estuvieran en inglés, y publicados entre enero de 1990 y agosto de 2019.

Resultados

Once estudios fueron incluidos (10 estudios observacionales y 1 ensayo clínico abierto). De estos, siete fueron cohortes, una serie de casos, y dos estudios de casos y controles. En total, 113 pacientes fueron incluidos en los estudios analizados. Todos los estudios utilizaron inhibidores de enzima convertidora de angiotensina como exposición, definición de caso, y/o comparador en ensayo clínico. Sobre la necesidad de diálisis, aproximadamente 53.9% de los pacientes la requirieron de forma temporal o permanente. Aproximadamente 6-27% de pacientes requirieron diálisis temporal, y 19-78% requirieron diálisis permanente. El rango de sobrevida al año fue de 64-84%; a dos años 53-74%; a cinco años 40-90%, y a diez años 35-47%.

Conclusiones

Los inhibidores de enzima convertidora de angiotensina continúan siendo la primera línea de tratamiento de crisis renal en esclerosis sistémica, al contribuir en la reducción de la mortalidad a corto plazo. Sin embargo, opciones terapéuticas alternativas son requeridas, al continuar muy elevado el porcentaje de requerimiento de diálisis. Ensayos clínicos futuros son necesarios para evaluar la eficacia y seguridad de diferentes opciones terapéuticas.

Palabras clave:
Crisis renal por esclerosis sistémica
Esclerosis sistémica
Falla renal aguda
Inhibidores de enzima convertidora de angiotensina
Antagonistas de receptor de Angiotensina

Article

These are the options to access the full texts of the publication Revista Colombiana de Reumatología (English Edition)
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Comprar
Comprar acceso al artículo

Comprando el artículo el PDF del mismo podrá ser descargado

Precio 19,34 €

Comprar ahora
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
Article options
Tools
Supplemental materials
es en pt
Política de cookies Cookies policy Política de cookies
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here. Utilizamos cookies próprios e de terceiros para melhorar nossos serviços e mostrar publicidade relacionada às suas preferências, analisando seus hábitos de navegação. Se continuar a navegar, consideramos que aceita o seu uso. Você pode alterar a configuração ou obter mais informações aqui.