目前治疗巨细胞动脉炎及其并发症
Elena Galli1,2, Francesco Muratore2,3, Kenneth J Warrington4
1Rheumatology Unit, Internal Medicine Department, ASST Settelaghi, Ospedale Di Circolo - Fondazione Macchi, Varese.
Current opinion in rheumatology
|June 26, 2024
概括
巨细胞动脉炎 (GCA) 管理正在发展. 托西利祖马布 (TCZ) 提供了一个有希望的替代方案来减少葡萄糖皮质醇 (GC) 的使用和复发,尽管正在研究新的治疗方法.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 内部医学 内部医学
背景情况:
- 巨细胞动脉炎 (GCA) 传统上需要长时间的葡萄糖皮质激素 (GC) 治疗.
- GC治疗与显著的长期发病率有关.
- 迫切需要替代疗法来管理GC和减少GC相关的不良影响.
研究的目的:
- 审查GCA目前的管理策略.
- 为了突出GCA的新兴疗法.
- 强调需要使用GC节约治疗和降低复发率.
主要方法:
- 审查最近的临床试验和GCA管理中的治疗发展.
- 对现有和新型GCA治疗方法的疗效和局限性的分析.
- 探索超越当前护理标准的替代治疗目标.
主要成果:
- 托西利祖马布 (TCZ) 是一种IL-6受体抑制剂,在减少GCA爆发和允许GC减少方面表现出有效性.
- 正在探索更快的GC逐渐减排方案,以减轻GC相关的不良事件.
- 替代性途径如IL-17A,T细胞激活和JAK-STAT正在研究新型GCA治疗.
结论:
- 作为GCA的GC节约剂,TCZ是一个显著的进步,但最佳的治疗持续时间和长期结果需要进一步研究.
- 对于没有反应或不符合TCZ条件的患者,仍然存在未满足的需求.
- 针对新的途径显示出希望,但需要更大的随机对照试验来获得明确的证据.
更多相关视频
相关概念视频
Angle Closure Glaucoma: Treatment
471
Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
471
Myasthenia Gravis: Overview and Treatment
1.3K
Myasthenia gravis is a neuromuscular transmission disorder characterized by weakness and increased fatigability of skeletal muscles. It is an autoimmune disease affecting approximately one in 2000 people, where antibodies against the α1 subunit of nicotinic acetylcholine receptors are produced.
These antibodies interfere with the function of the nicotinic receptors in three ways: by binding to the receptor and disrupting acetylcholine binding; by causing cross-linking of receptors which...
These antibodies interfere with the function of the nicotinic receptors in three ways: by binding to the receptor and disrupting acetylcholine binding; by causing cross-linking of receptors which...
1.3K
Open Angle Glaucoma: Treatment
427
In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
Drugs such as carbonic anhydrase inhibitors, α2- and...
Drugs such as carbonic anhydrase inhibitors, α2- and...
427
Gastritis III: Clinical Manifestations and Management
214
The clinical manifestations of gastritis can vary depending on the cause and type of gastritis, but some common symptoms may include the following.
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
214
Glaucoma: Overview
538
Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
538
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
419
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
419


