巨细胞关节炎和多肌痛性风湿症:治疗方法和新目标
Desh Nepal1, Michael Putman1, Sebastian Unizony2
1Department of Medicine, Division of Rheumatology, Hub for Collaborative Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Rheumatology, 6th Floor, Milwaukee, WI 53226, USA.
Rheumatic diseases clinics of North America
|June 18, 2023
概括
巨细胞动脉炎 (GCA) 和多肌痛性风湿性肌痛 (PMR) 的治疗方法正在发展,超出了长期使用葡萄糖皮质激素的范围. 本综述探讨了新的治疗目标和策略,以改善患者的治疗结果并减少类固醇毒性.
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:
- 葡萄糖皮质类药物是巨细胞动脉炎 (GCA) 和多肌痛类风湿 (PMR) 的标准.
- 进步改善了GCA结果,并减少了类固醇毒性.
- 持久性或复发性疾病和高累积的皮质糖类药物暴露仍然是GCA和PMR患者的挑战.
研究的目的:
- 定义目前的GCA和PMR治疗方法.
- 确定GCA和PMR的新治疗目标和策略.
- 审查专注于抑制细胞因子通路的新兴治疗方法.
主要方法:
- 对GCA和PMR治疗研究的文献综述.
- 专注于新的治疗目标和策略.
- 审查细胞因子通路的抑制,包括IL-6,IL-17,IL-23,GM-CSF和JAK-STAT通路.
主要成果:
- 目前对GCA和PMR的治疗涉及长时间的葡萄糖皮质醇缩小.
- 最近的进展为GCA提供了改善的结果,降低了毒性.
- 许多患者仍然面临持续性或复发性疾病,需要新的治疗选择.
结论:
- 新的治疗目标和策略对于管理GCA和PMR至关重要.
- 抑制特定的细胞因子通路对未来的治疗有希望.
- 减少累积的皮质糖类药物暴露是GCA和PMR管理的一个关键目标.
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