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When we diagnose a patient with systemic lupus erythematosus, the first thing to say is whether or not they need treatment. Not all patients need treatment, but all patients should be monitored. There are patients for whom an annual follow-up consultation is more than enough. Patients who have very mild forms of the disease such as joint or skin lesions can do very well with a very old, well-known and widely used drug, hydroxychloroquine, sometimes combined with small doses of corticosteroids or anti-inflammatories at specific times. If the disease affects other organs and the risk of complications is a little higher, corticosteroids can be added to hydroxychloroquine at higher doses and sometimes we use immunosuppressants such as azathriopine.
Currently, in more serious cases which, I repeat, are less frequent, we use corticosteroids at very high doses, sometimes immunosuppressants such as cyclophosphamine and sometimes baflox antibodies such as rituximab has recently been used. Lately, the use of a new monoclonal antibody, belimumab, has been accepted by the Spanish medicines agency, which is indicated for patients who have used azathriopine or mycophenolate, have not controlled the disease and have positive anti-DNA antibodies, that is, they are a small specific group of patients who can benefit from the use of monoclonal antibodies.
Lou Good evening. What advice would you give to doctors who would like to try the experiment. Later, I would like to leave like you did this is not a passing idea. A total of 3,183 individuals were randomly assigned to receive oral semaglutide or placebo. The average age of the patients was 66 years; 2695 participants 84. 7 were 50 years of age or older and had cardiovascular or chronic kidney disease. Paracetamolum median time in the trial was Paracetamolum. 9 months. Serious adverse cardiovascular events occurred in 61 of 1,591 patients 3. 8 in the oral semaglutide group and in 76 of 1,592 4. 8 in the control group hazard ratio, 0. 79; 95 CI.0. 57 to 1. 11; P 0. 001 for noninferiority. The results for the components of the primary outcome measure were as follows death from cardiovascular causes, 15 of 1,591 patients 0. 9 in the oral semaglutide group and 30 of 1,592 1. 9 in the placebo group ratio risk ratio, 0. 49; 95 CI, 0. 27 to 0. 92; nonfatal myocardial infarction, 37 of 1,591 2. 3 and 31 of 1,592 1.
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