与活跃的中度至重度甲状腺眼病对静脉注射葡萄皮质激素的反应相关的因素
Natalia Baczewska1, Orsalia Alexopoulou1, Stefan M Constantinescu1
1Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
概括
静脉注射葡萄皮质激素 (IVGCs) 有效治疗甲状腺眼病 (TED). 然而,老年患者和在治疗前临床活性得分 (CAS) 高的患者的反应较差,这表明替代疗法可能对他们来说更好.
科学领域:
- 眼科医生 眼科 眼科
- 内分泌学 在内分泌学.
- 免疫学 免疫学 免疫学
背景情况:
- 静脉注射葡萄皮质激素 (IVGCs) 是由于其抗炎性质而对中度至严重的甲状腺眼病 (TED) 的首要治疗方法.
- 患者对IVGCs的反应可能有所不同,因此需要确定影响治疗疗效的因素.
研究的目的:
- 评估活跃中度至重度TED患者对IVGCs的反应率.
- 确定与IVGCs治疗反应或不反应相关的患者特征.
主要方法:
- 追溯性队列研究,对64名活跃中度至重度TED患者进行了追溯性队列研究,接受了12周IVGC协议治疗.
- 使用临床判断 (CL) 和EUGOGO 2021修订复合指数 (CI) 评估患者反应.
- 多变量逻辑回归用于识别与IVGC反应相关的独立因素.
主要成果:
- 在治疗后6个月,整体应答率为75% (CL) 和73% (CI).
- 在IVGC开始时的年龄较大和治疗前的临床活性得分 (CAS) 更高,独立地与反应较差有关.
- 在CL和CI评估中确定了预测较差反应的最佳CAS截止值.
结论:
- 高龄和较高的基线CAS预测活跃中度至重度TED患者对IVGCs的反应较差.
- 考虑替代性免疫疗法作为一线治疗可能对具有这些特征的患者有益.
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