托西利祖马布可以消除GCA中的炎症吗? 一项对重复动脉活检的队列研究
Caterina Ricordi1,2, Chiara Marvisi1,2, Pierluigi Macchioni1
1Unit of Rheumatology, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy.
RMD open
|December 31, 2024
概括
接受托西利祖马布 (TCZ) 和葡萄糖皮质体 (GCs) 治疗的巨细胞动脉炎 (GCA) 患者在超过三分之一的病例中仍然表现出持续的血管炎症,即使经过长期治疗,通过重复活检和成像检查得到证实. 这突显了GCA持续的炎症活动,尽管结合治疗.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 病理学 病理学 病理学
背景情况:
- 巨细胞动脉炎 (GCA) 的特点是,尽管长期使用葡萄糖皮质激素 (GC) 治疗,但在动脉活检 (TAB) 中,血管炎症持续.
- 评估将托西利祖马布 (TCZ) 添加到GC治疗中的疗效对于管理GCA至关重要.
研究的目的:
- 在患有巨细胞动脉炎 (GCA) 的患者中,评估结合托西利祖马布 (TCZ) 与葡萄糖皮质类药物 (GCs) 的组织学和成像影响.
- 为了确定TCZ和GC治疗后GCA患者血管炎症的持续性.
主要方法:
- 连续的GCA患者在诊断时有炎症TAB,接受TCZ和GC治疗≥6个月,被纳入.
- 在诊断后两周内进行了重复TAB,PET/CT和CDUS,并与治疗前发现进行了比较.
主要成果:
- 在TCZ治疗中位数为2.4年后,38.5%的患者在重复TAB时仍然表现出炎症.
- 定子发射断层扫描/计算机断层扫描 (PET/CT) 在33.3%的患者中显示出持续的血管炎活动,平均血管活动得分显著降低.
- 彩色多普勒超声波 (CDUS) 显示,大约三分之一的患者患有动脉血管炎.
结论:
- 超过三分之一的GCA患者表现出持续的血管炎症,即使在长期治疗托西利祖马布 (TCZ) 和葡萄皮质激素 (GCs) 后.
- 病理和成像评估证实,尽管结合治疗,但在很大比例的GCA患者中持续存在炎症活动.
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