一项随机对照试验比较了缓解诱导与转基因多目标疗法,其中包括静脉注射环胺,用于扩散性狼性炎
Atanu Pal1, Arpita Ray Chaudhury1, Abhirup Bhunia1
1Department of Nephrology IPGMER, Kolkata, West Bengal, India.
Indian journal of nephrology
|October 26, 2023
概括
使用阿扎西奥普林的修改多目标疗法 (MMTT) 与静脉注射环胺 (IV CYC) 在治疗多发性狼性炎 (PLN) 中同样有效. 这种MMTT方法提供了可比的安全性,使其成为PLN诱导疗法的可行替代方案.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 免疫学 免疫学 免疫学
- 类风湿病学 类风湿病学
背景情况:
- 扩散性狼性炎 (PLN) 的标准治疗包括静脉注射环胺 (IV CYC) 和类固醇,但存在关于末期病 (ESRD) 进展,死亡率和不良影响的担忧.
- 使用塔克罗利斯,酸和类固醇的多目标疗法 (MTT) 可以诱导缓解,但与高感染率有关.
研究的目的:
- 为了评估修改多目标疗法 (MMTT) 的疗效和安全性,用于 PLN 诱导,用阿扎西奥普林取代甲酸盐.
- 为了比较MMTT与标准IVCYC疗法在活检证明PLN的患者.
主要方法:
- 一个单中心,24周,开放标签,随机对照试验进行了与18-65岁的成年人进行了活检证明的PLN.
- 干预组包括MMTT (塔克罗利斯和阿扎西奥普林) 和IV CYC,两者结合甲基普雷迪尼索隆和口服普雷迪尼松.
主要成果:
- 在24周的MMTT (86.36%) 和IV CYC (87.75%) 之间,整体缓解率是可比的.
- 这两组在蛋白尿,SLEDAI评分和C3补充水平上均有相似的改善.
- 在IV CYC组中,不良事件的数量更高,包括1例肺炎死亡.
结论:
- 修改的多目标疗法 (MMTT) 在PLN的短期结果中显示出与IV CYC可比的疗效.
- MMTT与IV CYC具有相似的安全性,这表明它是PLN诱导的潜在更安全的替代品.
更多相关视频
相关概念视频
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
170
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
170
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
148
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
148
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
122
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
122


