瑞图西马布诱导和再诱导在多炎和微观多炎的颗粒瘤中:台湾的一个回顾性多中心研究
Tsu-Yi Hsieh1,2, Ming-Han Chen3,4, Chen-Ching Wu5
1Division of Allergy, Immunology, and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan.
International journal of rheumatic diseases
|October 3, 2023
概括
与多炎 (GPA) 和显微多炎 (MPA) 发生的颗粒瘤的瑞图西马布诱导疗法显示出显著的死亡率,特别是在MPA患者中. 在幸存者中,年龄较小和抗PR3阳性预测了需要再诱导治疗的复发.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 带有多叶膜炎 (GPA) 的粒状瘤和显微多叶膜炎 (MPA) 是严重的自身免疫性疾病.
- 利图西马布是治疗这些疾病的关键疗法,但结果可能会有所不同.
- 了解不同患者群体的治疗反应至关重要.
研究的目的:
- 评估Rituximab诱导和再诱导治疗在台湾GPA和MPA患者的临床结果.
- 为了确定与这些患者的死亡率和复发相关的因素.
主要方法:
- 在2008年至2020年期间,对53名用Rituximab治疗的GPA或MPA患者的回顾性分析.
- 在GPA和MPA队列之间的临床特征和结果的比较.
- 对影响死亡率,置换疗法和需要重新诱导的复发因素的分析.
主要成果:
- 与GPA患者相比,微观多炎 (MPA) 患者的脏参与率和初始肌素水平较高.
- 在MPA患者中,在Rituximab初始治疗24周内发生了7例死亡 (20%),主要是由于感染.
- 在33名因脏干扰而接受治疗的患者中,23名患者在24周后避免了脏替代疗法;需要重新诱导的复发发生在39.1%的幸存者中,与抗PR3阳性和年轻年龄 (<50) 相关.
结论:
- 利图西马布诱导疗法与显著的死亡率有关,特别是在MPA患者中.
- 年龄较小 (<50岁) 和抗PR3阳性是GPA和MPA幸存者的复发需要再诱导治疗的危险因素.
- 在接受Rituximab治疗的患者中,密切监测感染和复发是必不可少的.
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