关于管理晚发性类风湿性关节炎的共识声明
Masayo Kojima1,2, Takahiko Sugihara3, Yutaka Kawahito4
1Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan.
Modern rheumatology
|March 21, 2024
概括
日本专家为晚发性类风湿性关节炎 (LORA) 的初始治疗制定了共识陈述. 建议使用甲托雷克萨特,对老年患者进行LORA治疗有特别的考虑.
科学领域:
- 类风湿病学 类风湿病学
- 老年医学 老年医学
- 临床流行病学临床流行病学
背景情况:
- 晚期类风湿性关节炎 (LORA) 正在增加,但缺乏确定的初始治疗指南.
- 对LORA的基于证据的初始治疗策略存在差距,需要专家的共识.
研究的目的:
- 通过制定关于LORA初始治疗的共识陈述来解决缺乏证据的问题.
- 为管理LORA的日本风湿病专家提供专家指导.
主要方法:
- 采用了经过修改的Delphi方法,涉及一个指导委员会和专家小组.
- 来自老年病专家,流行病学家,指导方针制定者,患者团体和LORA研究小组委员会.
- 文献审查和队列数据分析为达成共识的过程提供了信息.
主要成果:
- 确定了四个确定的事实,三个基本方法和六个专家意见,用于LORA管理.
- 甲托雷克萨特被推作为LORA的第一线治疗.
- 对于不对甲状腺素反应的病例,考虑分子向药物;由于并发症和认知因素,对老年患者的仔细评估至关重要.
结论:
- 对于初始LORA治疗的13个共识陈述得到了专家的证据和改进.
- 计划在未来对新LORA病例进行注册研究进行验证.
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