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Examination of Oral Candida Infection in Primary Sjögren's Syndrome Patients
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原发性Sjögren综合征的治疗:一个系统性审查
Manuel Ramos-Casals1, Athanasios G Tzioufas, John H Stone
1Sjögren Syndrome Research Group (AGAUR), Josep Font Laboratory of Autoimmune Diseases, IDIBAPS, Department of Autoimmune Diseases, Hospital Clínic, C/Villarroel, 170, 08036 Barcelona, Spain. mramos@clinic.ub.es
JAMA
|July 29, 2010
概括
缺乏对初级Sjögren综合征治疗的基于证据的指导方针. 皮洛卡尔和塞维梅林显示对西卡症状有好处,而局部环素则有助于中度至严重的干眼.
科学领域:
- 风湿病学和免疫学
- 眼科医生 眼科 眼科
- 药理学 药理学是指药理学的学科.
背景情况:
- 主要Sjögren综合征 (pSS) 是一种慢性自身免疫性疾病,影响外分泌腺,导致干燥.
- 目前对PSS的治疗选择缺乏全面的基于证据的指南.
- 管理pSS症状,特别是Sicca症状,仍然是一个临床挑战.
研究的目的:
- 系统地审查和总结有关初级Sjögren综合征药物治疗的证据.
- 根据随机对照试验 (RCT) 评估各种局部和全身药物的疗效.
- 为未来PSS管理治疗指南的制定提供信息.
主要方法:
- 从1986年1月到2010年4月,对MEDLINE和EMBASE数据库进行了系统的文献搜索.
- 包括随机对照试验 (RCT),评估原发性Sjögren综合征的成年患者的局部和全身药物治疗.
- 专注于评估对Sicca症状和其他相关结果的疗效的试验.
主要成果:
- 局部眼部0.05%环素显示,干眼参数显著改善.
- 与安慰剂相比,皮洛卡尔和塞维梅林在改善口腔干燥和眼睛干燥症状方面表现出显著的有效性.
- 在小规模试验中,口服的普得尼松,氧化,阿扎西奥普林和环素对sicca症状的益处有限或不显著;抗TNF药物和rituximab表现出不确的疗效,需要进一步调查.
结论:
- 皮洛卡尔和塞维梅林在初级Sjögren综合征中有效管理sicca特征.
- 局部使用的环素为PSS中中度至重度眼睛干燥提供了有益的治疗选择.
- 目前的证据不支持抗瘤亡因子剂的疗效;对于rituximab,需要进行更大的试验.
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