免疫检查点抑制剂相关心肌炎的治疗
Julius C Heemelaar1,2, Maria Louisa2, Tomas G Neilan1
1Cardiovascular Imaging Research Center (CIRC), Department of Cardiology and Radiology, Massachusetts General Hospital, Boston, MA; and.
Journal of cardiovascular pharmacology
|July 28, 2023
概括
免疫检查点抑制剂 (ICI) 可以导致严重的心肌炎. 皮质类固醇是标准治疗,但许多患者需要更好的选择,突出显示了对ICI相关心肌炎的新疗法的需求.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
背景情况:
- 免疫检查点抑制剂 (ICI) 改善癌症生存率,但可能导致严重的免疫相关不良事件.
- 心肌炎是ICI治疗的罕见但可能致命的心血管并发症.
- 目前使用高剂量的皮质类固醇治疗往往不足,一半的患者没有改善.
研究的目的:
- 审查目前的文献,指导方针和未来的指导方针,用于ICI相关心肌炎的药理治疗.
- 解决最佳的二线治疗策略的证据差距.
- 探索转向加强免疫抑制或向治疗的范式转变.
主要方法:
- 对观察性研究和案例报告的文献综述.
- 分析现有的治疗指南.
- 讨论新兴的治疗策略.
主要成果:
- 高剂量的皮质类固醇是ICI心肌炎的主要治疗方法.
- 很大一部分患者对单独的皮质类固醇药物没有反应.
- 目前正在研究涉及加强免疫抑制或向治疗的新策略.
结论:
- 需要改善ICI相关心肌炎的治疗策略.
- 目前对新型二线治疗的证据有限但有希望.
- 为了建立最佳的药理学方法,进一步的研究至关重要.
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