管理成人发病的斯蒂尔病:专家基于证据和共识的建议
Helen L Leavis1, Paul L A van Daele2, Catharina Mulders-Manders3
1Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.
Rheumatology (Oxford, England)
|September 5, 2023
概括
专家们就诊断和治疗成年始终发病症达成共识.
科学领域:
- 类风湿病学 类风湿病学
- 内部医学 内部医学
- 儿科 儿科 儿科
背景情况:
- 成人发病的斯蒂尔病 (AOSD) 是一种罕见的全身炎症疾病.
- 对于AOSD存在有限的治疗指南,这给每年管理少数病例的临床医生带来了挑战.
- 制定基于共识的建议对于标准化患者护理至关重要.
研究的目的:
- 建立专家对AOSD诊断和治疗策略的共识.
- 为AOSD的临床治疗算法奠定基础.
- 为了解决这种罕见疾病缺乏国际治疗指南的问题.
主要方法:
- 一个德尔菲小组由18名AOSD专家 (风湿病学家,内科医生,儿科医生) 组成.
- 该过程涉及三轮:在线问卷调查和最终投票的虚拟会议.
- 共识被定义为80%的同意,得到文献搜索的支持.
主要成果:
- 在涵盖AOSD诊断,反应评估和治疗的29个陈述上达成共识.
- 专家们一致同意减少葡萄糖皮质激素的使用,以尽量减少副作用.
- 生物药物比传统治疗更受青,强调IL-1和IL-6抑制剂.
结论:
- 在AOSD诊断和治疗建议方面达到了高水平的专家共识.
- 这些共识声明为制定急需的治疗指南提供了基础.
- 这些发现支持在AOSD管理中转向生物药物和减少葡萄糖皮质体使用.
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