用药理疗法治疗牛皮关节炎的EULAR建议:2023年更新
Laure Gossec1,2, Andreas Kerschbaumer3, Ricardo J O Ferreira4,5
1INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Universite, Paris, France laure.gossec@aphp.fr.
Annals of the rheumatic diseases
|March 18, 2024
概括
欧洲反风湿联盟 (EULAR) 的最新指导方针为牛皮关节炎 (PsA) 提供了一种渐进的药理治疗策略. 这些建议优先考虑早期使用疾病修饰性抗风湿药物和基于疾病表现和患者因素的生物疗法.
科学领域:
- 类风湿病学 类风湿病学
- 药理学 药理学是指药理学的学科.
- 免疫学 免疫学 免疫学
背景情况:
- 牛皮关节炎 (PsA) 治疗需要更新建议,因为新的药物机制和扩展的疗效/安全数据.
- 针对PsA药理管理的EULAR 2019指南需要修订,以纳入最近的进展.
研究的目的:
- 更新EULAR对牛皮关节炎药理治疗的建议.
- 提供一个全面和渐进的治疗策略,整合PsA目前的药物选择.
主要方法:
- 根据EULAR标准化操作程序进行的系统文献审查.
- 在2023年4月举行的36名国际专家的共识会议上,最终确定了建议.
- 确定每个建议的证据水平和等级.
主要成果:
- 更新后的建议包括7个总体原则和11个针对PsA药理疗法的具体建议.
- 非类固醇抗炎药物只推用于轻度PSA短期;不建议服用口服葡萄糖皮质类药物.
- 对于外围的PsA,建议快速启动常规合成疾病修饰性抗风湿药物 (csDMARDs),最好是甲状腺素,如果目标不达成,建议随后采用生物DMARDs (bDMARDs).
- 针对显著皮肤牛皮的PsA,建议使用特定的bDMARDs (向IL-23,IL-17).
- 提供了轴向/肠道PSA的算法,并考虑了诸如炎症性肠病和脑膜炎等并发症.
- 简氏激酶 (JAK) 抑制剂在bDMARD失败后或当bDMARD不适合时被建议使用.
结论:
- 这些更新的EULAR建议为牛皮关节炎的药理管理提供了一种实用,渐进的方法.
- 该指南整合了所有可用的药物,帮助临床医生优化PsA治疗策略.
相关概念视频
01:26Peptic Ulcer Disease IV: Management
91
Medical treatment strategies for peptic ulcers encompass various methods. The primary goal of treatment is to diminish gastric acidity and strengthen mucosal defense mechanisms.
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
91
01:28Drug Therapy
43
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
43
01:17Drugs Used in Lower Respiratory Disorders: Overview
442
Lower respiratory tract disorders present challenges that often require skilled and nuanced approaches for effective management. Common ailments, such as asthma and chronic obstructive pulmonary disease (COPD), have prompted the development of intricate treatment strategies involving bronchodilators and anti-inflammatory drugs, each tailored to ease breathing and revitalize the lungs.
Bronchodilators, the first step of respiration enhancement, come in various forms, each with its own mechanism...
Bronchodilators, the first step of respiration enhancement, come in various forms, each with its own mechanism...
442
01:19Antiasthma Drugs: Leukotriene Modifiers
297
Leukotriene modifiers, or cysteinyl leukotriene receptor antagonists, are medications used to manage chronic asthma. These agents target specific inflammatory mediators produced during arachidonic acid metabolism, an essential process in generating inflammation in the body.
Leukotriene modifiers work through two distinct mechanisms:
Leukotriene modifiers work through two distinct mechanisms:
297
01:23Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
176
Prostacyclin receptor agonists are a class of therapeutic agents integral to managing pulmonary arterial hypertension (PAH). These drugs operate by mimicking the action of prostaglandin I2, or PGI2, a naturally occurring compound in the body.
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
176
01:18Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists
161
Endothelins (ETs) are potent vasoactive peptides critical in the human body's various physiological and pathological processes. One of the most promising therapeutic strategies for treating pulmonary arterial hypertension (PAH) involves counteracting the effects of these endothelins using a class of drugs known as endothelin receptor antagonists.
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
161