在老年患有类风湿性关节炎的患者中使用生物疗法的考虑因素
Noor Nooh1, May N Lwin1, Christopher Edwards1
1NIHR clinical research facility, Southampton General Hospital, Southampton University Hospitals NHS Trust, Southampton, UK.
Expert opinion on biological therapy
|September 13, 2024
概括
老年类类风湿性关节炎 (EORA) 的治疗是复杂的. 对于EORA患者来说,生物疗法是有效和安全的,而生物修饰性抗风湿药物 (bDMARD) 优先于向性合成DMARD (tsDMARD).
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 老年病的医生 老年病的医生
背景情况:
- 类风湿性关节炎 (RA) 主要影响中年人,但在老年人中越来越多.
- 老年发病的RA (EORA) 带来了独特的挑战,包括并发症和多药性.
- 关于老年RA患者的生物治疗安全性和疗效的数据有限.
研究的目的:
- 审查老年RA患者使用生物疗法.
- 为了评估EORA的治疗策略.
- 为了比较不同RA治疗在老年人的疗效和安全性.
主要方法:
- 发表文献的叙事审查.
- 包括随机对照试验和元分析.
- 考虑来自NICE和EULAR的指导方针.
主要成果:
- 甲托雷克萨特是EORA和年轻发病的RA (YORA) 的第一线治疗方法.
- 在EORA和YORA中,用甲状腺素和生物药物的联合治疗是安全有效的.
- 利图西马布在75岁以上的RA患者的疗效降低.
- 生物DMARDs (bDMARDs) 在针对老年RA患者的合成DMARDs (tsDMARDs) 上是首选的,因为安全性更好.
结论:
- 生物疗法是EORA的可行的治疗选择.
- 对于老年RA患者来说,bDMARDs具有有利的安全性.
- 对于EORA的治疗决定,应考虑患者的年龄和并发症.
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