抗纤维素药物在风湿性关节炎相关的间歇性肺病中的有效性和耐受性
Pierre-Antoine Juge1, Keigo Hayashi1, Gregory C McDermott1
1Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
Seminars in arthritis and rheumatism
|December 6, 2023
概括
抗纤维素药物在风湿性关节炎相关的间歇性肺病 (RA-ILD) 患者中适度改善了肺功能轨迹. 然而,不良事件导致常见的中止,肺移植和死亡率仍然很高.
科学领域:
- 类风湿病学 类风湿病学
- 肺部病理学 肺部病理学
- 药理学 药理学是指药理学的学科.
背景情况:
- 风湿性关节炎相关的间歇性肺病 (RA-ILD) 是致病率和死亡率的重要原因.
- 抗纤维化疗法为渐进性纤维化肺部疾病提供了潜在的治疗选择.
研究的目的:
- 评估RA-ILD患者抗纤维素药物的实际有效性和耐受性.
- 为了比较强迫生命能力 (FVC) 的轨迹,并确定与RA-ILD患者治疗抗纤维素药物相关的因素.
主要方法:
- 在74名RA-ILD患者的回顾性队列研究中,开始使用宁泰达尼布或皮尔芬尼.
- 分析肺功能测试 (PFT),不良事件 (AE) 和生存数据.
- 在抗纤维素启动前和之后的FVC预测百分比 (FVCpp) 斜率的统计比较.
主要成果:
- 抗纤维素药物启动与FVCpp轨迹的显著改善有关 (p=0.03).
- 胃肠道副作用很常见 (55%),导致46%的患者停止治疗.
- 肺移植或死亡发生在40%的患者中,男性性别和重度吸烟是危险因素.
结论:
- 在现实世界RA-ILD队列中,抗纤维素治疗对肺功能轨迹产生了适度的益处.
- 高AEs和停产率凸显了耐受性挑战.
- 尽管有治疗,但显著的死亡率和肺移植率强调了需要改善严重RA-ILD的治疗策略.
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