[低剂量甲状腺素:说明和副作用,特别是在扩散性间歇性肺炎的情况下]
M David1, P Dieude2, M P Debray3
1Service de pneumologie A, hôpital Bichat, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France; Université Paris Cité, Inserm, PHERE, 75018 Paris, France.
Revue des maladies respiratoires
|July 18, 2024
概括
低剂量甲状腺素 (MTX) 对于类风湿性关节炎 (RA) 患者来说是安全的,即使有间歇性肺部疾病 (ILD). 最近的研究证实MTX-LD可以在RA-ILD病例中使用,而不会增加毒性风险.
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:
- 甲甲酸 (MTX) 是一种对类风湿性关节炎 (RA) 的重要免疫抑制剂.
- 有关MTX-LD毒性的担忧存在,可能限制其使用.
- 之前的研究表明,RA患者有间歇性肺病 (ILD) 的MTX毒性风险增加.
研究的目的:
- 评估低剂量甲状腺素 (MTX-LD) 在类风湿性关节炎 (RA) 患者的安全性,这些患者有间歇性肺病 (RA-ILD).
- 为了澄清MTX-LD与RA-ILD患者中毒性的关联.
主要方法:
- 对回顾性队列数据的审查.
- 对最近的前性和后性多中心研究进行分析.
主要成果:
- 与之前的报道相反,最近的多中心研究没有发现RA-ILD患者的MTX毒性风险增加.
- 对于RA患者,包括RA-ILD患者,MTX-LD被认为是安全的.
结论:
- 对于RA患者,即使是那些患有RA相关的ILD患者,MTX-LD也可以安全地处方.
- 目前的建议支持在RA患者中使用MTX,这些患者有ILD风险或轻度至中度RA-ILD.
相关概念视频
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
156
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
156
Pulmonary Tuberculosis I
228
Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
228
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
113
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
113
Antiasthma Drugs: Leukotriene Modifiers
269
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:
269
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
127
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
127
Drugs Used in Lower Respiratory Disorders: Overview
390
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...
390


