在患有牛皮关节炎的患者中使用向治疗的治疗和对甲索特雷克萨特的不充分反应:为合理的战略提出建议
Philippe Goupille1, Guillermo Carvajal Alegria2, Frank Verhoeven3
1Rheumatology Department, CHU de Tours, UPR CNRS 4301 CBM, NMNS, University of Tours, 37044, Tours Cedex 9, France. goupille@med.univ-tours.fr.
对于牛皮关节炎患者,如果甲索特雷克萨特治疗失败,建议继续用抗TNFα治疗. 使用其他向疗法,如抗IL-17或JAK抑制剂,也可能停止使用甲状腺素.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 牛皮关节炎 (PsA) 治疗选择正在扩大,需要最佳地使用向疗法.
- 甲托雷克萨特 (MTX) 是一种常见的PsA初始治疗方法,但许多患者最终需要替代或额外的疗法.
研究的目的:
- 为了指导选择第一线针对性治疗的PsA患者谁没有充分响应甲状腺酸盐.
- 为优化基于药物类别和患者反应的治疗选择提供合理的策略.
主要方法:
- 使用关键词与MTX耐受性,组合治疗疗效和向药物的免疫性相关的PubMed文献综述.
- 对抗瘤亡因子α (TNFα) 和抗介素 (IL) 治疗的治疗维护数据的分析.
- 对各种针对性治疗的免疫性和维持策略的评估.
主要成果:
- 建议继续用抗瘤缩因子α (TNFα) 药物治疗甲状腺素,以防止免疫性并保持治疗效果.
- 在评估疗效后,在开始使用抗干白素 (IL-17) 剂,抗IL-12/23 剂,抗IL-23 剂或Janus 激酶 (JAK) 抑制剂时,停止使用甲醇可能是可行的.
- 继续或停止使用甲状腺素的决定应以特定的向治疗和患者的反应为指导.
结论:
- 这项研究提供了一种基于文献的策略,以指导在MTX失败的PsA患者中进行一线向治疗选择.
- 优化向治疗选择可以改善牛皮关节炎的治疗结果和治疗坚持.
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