针对全身性硬化症治疗的EULAR建议:2023年更新
Francesco Del Galdo1,2, Alain Lescoat3, Philip G Conaghan4,2
1Leeds Institute of Rheumatic and Musculoskeletal Medicine, LIRMM, Leeds, UK f.delgaldo@leeds.ac.uk.
Annals of the rheumatic diseases
|October 11, 2024
概括
更新的欧洲风湿病学协会联盟 (EULAR) 对全身性硬化症 (SSc) 治疗的建议包括新的证据和疗法. 关键的更新包括针对纤维化表现的向疗法和新的研究重点.
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:
- 系统性硬化症 (SSc) 是一种复杂的自身免疫性疾病,其特征是纤维化,血管功能障碍和免疫失调.
- 现有的治疗指南需要更新,以反映治疗选择的进步和对SSc病理生理学的理解.
研究的目的:
- 修订和更新2017年欧洲风湿病学协会联盟 (EULAR) 关于管理系统性硬化症 (SSc) 的建议.
- 将新的证据和新兴疗法纳入SSc治疗的临床实践指南.
主要方法:
- 根据EULAR标准操作程序召开了一个国际工作组.
- 一个系统的文献审查,通过名义组技术和代投票轮进行信息化.
- 在8个临床领域制定了22项建议,包括雷诺现象,数字,肺动脉高血压,硬化硬质,危机,皮肤纤维化,间歇性肺病 (ILD),胃肠道表现和关节炎.
主要成果:
- 新的建议集中在皮肤纤维化和间歇性肺病 (ILD) 上,包括mycophenolate mofetil, nintedanib, rituximab 和 tocilizumab.
- 目前的指导方针包括一线和二线干预措施,以提高临床效用.
- 更新后的议程优先考虑对血管,肌肉骨,胃肠道表现,和数字的新型治疗方法的研究.
结论:
- 这些更新的EULAR建议引入了针对纤维化SSc表现的有针对性的合成和生物疗法.
- 现在建议对新诊断的肺动脉高血压进行一线联合治疗.
- 为未来的SSc管理策略制定了优先级研究议程.
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