托西利祖马布和利图西马布用于全身性硬化症间歇性肺病:现实世界的队列分析
Nina R Goldman1, Svetlana I Nihtyanova1,2, Claire F Beesley1
1Centre for Rheumatology, Division of Medicine, University College London, London, United Kingdom.
Rheumatology (Oxford, England)
|January 3, 2025
概括
利图西马布和托西利祖马布稳定了系统性硬化症-间歇性肺病患者的肺功能,这些患者对标准疗法不耐药. 抗毒素酶抗体阳性患者对tocilizumab的反应有所改善.
科学领域:
- 类风湿病学 类风湿病学
- 肺部病理学 肺部病理学
- 免疫学 免疫学 免疫学
背景情况:
- 系统性硬化症-间歇性肺病 (SSc-ILD) 是SSc中死亡的主要原因.
- 有限的数据存在于Rituximab和tocilizumab对于SSc-ILD患者的标准疗法失败.
研究的目的:
- 评估Rituximab和tocilizumab在SSc-ILD耐受标准免疫抑制剂的患者中的疗效.
- 为了确定与治疗反应相关的患者特征.
主要方法:
- 在单个中心对接受Rituximab或Tocilizumab治疗的SSc患者的回顾性分析.
- 线性混合效应模型用于分析治疗前后的肺功能 (FVC,DLCO) 轨迹.
主要成果:
- 在不耐药的SSc-ILD患者中,rituximab和tocilizumab都稳定了肺功能 (%FVC/年和%DLCO/年).
- 抗毒素酶抗体 (ATA) 阳性患者表现出显著的%FVC/年对tocilizumab的反应.
- 与女性相比,男性患者对rituximab的FVC/年响应率更高.
结论:
- 与背景免疫抑制剂结合的利图西马布或托西利祖马布可以稳定耐火性SSc-ILD患者的肺功能.
- 患者的特征,包括ATA状态和性别,影响治疗反应.
- 这些发现支持托西利祖马布在ATA阳性SSc-ILD患者中的疗效,与RCT数据保持一致.
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