合成DMARDs的相互作用和剂量建议的评估 - 基于系统文献搜索的基于证据和基于共识的建议
C Fiehn1,2, J Leipe3,4, C Weseloh3,5
1Kommission Pharmakotherapie, Deutsche Gesellschaft für Rheumatologie (DGRh), Berlin, Germany. c.fiehn@rheuma-badenbaden.de.
Zeitschrift fur Rheumatologie
|October 13, 2023
概括
这项研究提供了基于证据的建议,以在风湿性关节炎患者中安全使用疾病修饰性抗风湿药物 (DMARD),重点关注药物相互作用和针对功能和年龄的剂量调整.
科学领域:
- 类风湿病学 类风湿病学
- 临床药理学 临床药理学
- 基于证据的医学基于证据的医学.
背景情况:
- 传统的合成药物和有针对性的合成药物改变疾病的抗风湿药物 (DMARDs) 对于治疗类风湿性关节炎至关重要.
- 这些DMARD可以产生显著的药物相互作用和改变治疗指数,特别是在器官功能受损或晚年患者中.
- 最佳的治疗策略需要明确的指导来管理这些复杂性.
研究的目的:
- 为DMARDs的治疗用途制定基于证据的建议.
- 为了解决潜在的药物相互作用,并为功能受限患者和老年人提供剂量建议.
- 为了提高DMARD治疗风湿性关节炎的安全性和有效性.
主要方法:
- 进行了系统的文献搜索,以确定在特定患者群体中对DMARD药物相互作用和剂量的研究.
- 选了2756个出版物,154个被选中进行审查,68个被详细分析.
- 还分析了产品信息,随后进行了共识过程,以制定建议和相互作用分类 (A-D).
主要成果:
- 在合成DMARD和其他药物之间发现了许多潜在的相互作用,并评估了临床意义.
- 制定了建议,将相互作用从危险的组合归类为在标准剂量下不相关的相互作用.
- 根据功能和年龄,为csDMARDs和tsDMARDs制定了剂量建议.
结论:
- 该研究提供了3个主要和11个核心建议,以帮助治疗决策.
- 这些建议旨在通过管理DMARD相互作用和剂量来提高类风湿性关节炎治疗的安全性.
- 为临床医生提供实用指导,治疗患有特定伴随性疾病或年龄相关因素的患者.
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