阿扎西奥普林与甲索特雷克萨特在聚炎的eosinophilic granulomatosis中:一个单中心的回顾性研究
Alessandra Milanesi1,2,3, Paolo Delvino1,2,3, Silvana Quaglini4
1Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy.
Rheumatology (Oxford, England)
|June 16, 2023
概括
阿扎西奥普林 (AZA) 和甲铁酸盐 (MTX) 能够有效地诱导聚炎症的eosinophilic granulomatosis的缓解. 在某些患者群体中,MTX显示出更早的缓解和更好的类固醇节约效果.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 带有多炎 (EGPA) 的异性粒状炎是一种罕见的全身性血管炎.
- 有效的诱导和维持疗法对于管理EGPA和预防复发至关重要.
研究的目的:
- 评估EGPA治疗中阿扎西奥普林 (AZA) 和甲铁酸盐 (MTX) 的疗效,安全性和类固醇节约潜力.
- 将AZA和MTX作为EGPA患者的初始治疗和维持治疗进行比较.
主要方法:
- 对57名EGPA患者的回顾性分析,分为四个治疗组 (MTX/AZA作为一线或二线治疗).
- 评估五年内缓解率 (BVAS=0,使用不同的普雷尼松剂量),治疗持久性,累积葡萄糖皮质激素剂量,复发频率和不良事件.
主要成果:
- 在MTX和AZA组之间,整体缓解率 (R1) 没有显著差异.
- 甲托雷克萨特 (MTX) 在第一线治疗的前六个月导致更早的缓解 (R2) (MTX1与AZA1).
- 甲托雷克萨特 (MTX) 在二线维持疗法 (MTX2与AZA2) 中表现出优异的类固醇节约作用,累计葡萄糖皮质激素剂量较低. 阿扎西奥普林 (AZA) 与第二线组 (AZA2) 的喘/ENT复发率较少有关. 甲托雷克萨特 (MTX) 与更多不良事件有关.
结论:
- 阿扎西奥普林 (AZA) 和甲状腺 (MTX) 两种药物都有效地实现EGPA患者的缓解.
- 甲托雷克萨特 (MTX) 在实现更早的缓解和减少葡萄糖皮质激素依赖方面具有优势,特别是在特定的治疗环境中.
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