环胺治疗与儿科风湿病学和儿科病学实践中的比较
Deniz Gezgin Yildirim1, Emine Yılmaz Orulluoglu2, Cisem Yildiz3
1Department of Pediatric Rheumatology, Faculty of Medicine, Gazi University, Ankara, 21000, Turkey. denizgezgin@gazi.edu.tr.
Pediatric rheumatology online journal
|March 12, 2025
概括
儿科专家更喜欢循环胺 (CYC) 而不是rituximab (RTX) 治疗儿童类类风湿性疾病,如SLE和AAV. 尽管有潜在的副作用,但高剂量的CYC疗法通常被使用.
科学领域:
- 儿科风湿病学 儿科风湿病学
- 儿科脏病学 儿科脏病学
- 免疫抑制疗法 免疫抑制疗法
背景情况:
- 环胺 (CYC) 是儿童类风湿性疾病的关键免疫抑制剂,通常与皮质类固醇一起使用.
- 利图西马布 (RTX) 是儿童类风湿性疾病的诱导疗法的新兴替代品.
- 对于CYC的临床实践在指示,剂量和监测方面有所不同.
研究的目的:
- 评估儿童类风湿病学和病学中CYC的使用原则.
- 为了比较临床医生在诱导治疗中CYC和RTX之间的偏好.
- 为了确定CYC在儿童发作的类风湿性疾病的使用当前的做法.
主要方法:
- 一个基于网络的问卷被分发给了87名儿科风湿病学家和病学家.
- 参与者评估了CYC的指示,同意,实验室测试,剂量和副作用.
- 在诱导疗法中,对CYC与RTX的偏好进行了比较.
主要成果:
- 儿童发病的SLE和AAV是CYC的主要征兆 (95%和69%).
- 静脉高剂量CYC (500 mg/m2 6个月) 是首选的治疗方案,与NIH协议保持一致.
- 通常监测的疫苗包括乙型肝炎,天花和MMR;不良影响范围从细胞衰减到不孕不育.
结论:
- 临床医生在SLE和AAV的诱导疗法中更喜欢CYC而不是RTX.
- 由NIH推的高剂量CYC疗法仍然是首选的治疗方法.
- 了解这些偏好为儿童类风湿性疾病的治疗指南提供了信息.
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