基于日本葡萄糖皮质类药物剂量的多发性肌痛类风湿症患者的特征:使用例行收集的健康数据进行队列研究
Yoshiya Tanaka1, Toshiya Takahashi2, Shoichiro Inokuchi3
1Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan.
Modern rheumatology
|January 17, 2025
概括
这项关于多发性肌痛风湿症 (PMR) 在日本的研究发现,伴随疾病的老年患者需要更高的葡萄糖皮质醇剂量. 许多患者没有达到缓解,突出了PMR治疗中未满足的医疗需求.
科学领域:
- 类风湿病学 类风湿病学
- 临床医学 临床医学
- 流行病学 流行病学
背景情况:
- 多发性肌痛风湿症 (PMR) 是一种影响老年人的炎症状况.
- 了解PMR患者的特征和治疗反应对于改善结果至关重要.
- 目前的治疗策略,主要是葡萄糖皮质激素,具有可变的疗效和潜在的副作用.
研究的目的:
- 在日本,对多发性肌痛风湿症 (PMR) 患者进行表征.
- 分析炎症标志物作为疾病活动的指标.
- 描述日本PMR队列中的治疗模式和结果.
主要方法:
- 来自日本电子医疗记录数据库的373名PMR患者的队列研究.
- 患者根据初始每日葡萄糖皮质体剂量 (Q1-Q4) 分为四分位数.
- 分析了52周的患者人口统计,并发症,炎症标志物和治疗反应.
主要成果:
- 最低葡萄糖皮质体剂量组 (Q1) 包括更多的老年患者 (≥90岁) 和具有较高并发症患病率的患者.
- 在52周内,只有10%的患者实现了无葡萄糖皮质激素缓解,并发现C-反应蛋白水平升高.
- 与较低剂量相比,较高的葡萄糖皮质体剂量 (Q4) 与较慢的C-反应蛋白减少和增加剂量升级需求相关.
- 伴随性疾病发生率因年龄而异:骨质疏松症和糖尿病在75岁以下更常见,高血压在75岁以上.
- 甲托雷克萨特的使用不常见 (4.3%-7.3%).
结论:
- 一部分PMR患者对高剂量葡萄糖皮质类药物表现出折射性.
- 接受低剂量葡萄糖皮质激素似乎不足的患者年龄较大,并患有更多的并发症.
- 这项研究强调了在多发性肌痛类风湿症的管理中存在重大未满足的医疗需求.
- 优化葡萄糖皮质激素治疗和探索替代治疗方法对于具有挑战性的PMR病例是有必要的.
更多相关视频
相关概念视频
01:21Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
95
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
95
01:25Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
217
Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
217
01:24Rational Dosage Regimen: Maintenance Dose and Loading Dose
3.8K
A rational dosage regimen considers a drug's pharmacokinetics, including its absorption, distribution, metabolism, and elimination from the body. By understanding these factors, the appropriate dosage can be determined, and the dosing schedule can be designed to achieve and maintain the desired therapeutic effect while minimizing adverse effects.
In most cases, drugs are administered repetitively or infused continuously to maintain a steady-state concentration in the body. At a steady...
In most cases, drugs are administered repetitively or infused continuously to maintain a steady-state concentration in the body. At a steady...
3.8K
01:01Dosage Regimen: Fixed Dose
1.8K
Fixed-dose regimens are a common approach to administer drugs to achieve and maintain desired levels of the drug in the body. In this dosing strategy, a specific amount of medication is given at regular intervals, often multiple times a day, to ensure a consistent drug concentration in the bloodstream.
Fixed-dose regimens can be used for various routes of administration, including intravenous (IV) injections and oral medications. For IV administration, a predetermined amount of the drug is...
Fixed-dose regimens can be used for various routes of administration, including intravenous (IV) injections and oral medications. For IV administration, a predetermined amount of the drug is...
1.8K
01:11Renal Failure: Dose Adjustments
61
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
61
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
141
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
141