在IgA脏病的临床实践模式:基于问卷的全球调查调查
Bhavik Bansal1, Amritesh Grewal1, Boon Wee Teo2
1All India Institute of Medical Sciences, New Delhi, India.
Kidney international reports
|December 18, 2023
概括
在全球范围内,IgA脏病的管理有所不同,共识是对氨酸- ангиотензин-阿尔多素系统的阻断,但支持性治疗和免疫抑制有所不同. 对Igan的临床试验入学率很低,特别是在中低收入国家.
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
- 临床医学 临床医学
背景情况:
- IgA脏病 (IgAN) 是一种常见的脏疾病,具有不同的种族表型.
- 了解全球管理策略对于标准化IGAN护理至关重要.
研究的目的:
- 调查 IgA 病的全球管理实践.
- 为了识别全球科医生之间治疗方法的差异.
主要方法:
- 一个全球性的,两步的在线调查被管理到科医生.
- 该调查侧重于IgAN的诊断标准,支持性治疗和免疫抑制策略.
主要成果:
- 大多数病学家使用氨酸- ангиотензин- алдостерон系统 (RAAS) 阻塞 (97.2%) 并考虑蛋白尿症 (87.9%) 和eGFR下降 (78.7%) 作为免疫抑制.
- 在使用SGLT2抑制剂等支持性疗法和临床试验招生方面存在显著的区域差异 (全球为30.4%,LMICs为8.1%).
- 皮质类固醇是主要的免疫抑制药物 (89.1%),而抗药性病例 (49.3%) 则使用mycophenolate mofetil.
结论:
- 虽然RAAS阻塞和血压控制是标准化的,但Igan管理在支持性护理和免疫抑制启动方面表现出异质性.
- 针对新型Igan治疗的临床试验的招生是有限的,特别是在中低收入国家,突出了获得先进疗法的差距.
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