免疫检查点抑制剂诱导的牛皮的系统治疗:基于推理的指导
Kim A Papp1,2,3, Luis Puig4,5,6, Jennifer Beecker1,7,8,9
1Probity Medical Research Inc., Waterloo, Ontario, Canada.
概括
牛皮的系统性药物 (saPs) 可以控制免疫检查点抑制剂介导的牛皮 (ICI-Ps),而不会显著影响癌症治疗的疗效. 通常,建议继续ICI治疗,而非类固醇SAPs优先于皮质类固醇.
科学领域:
- 在瘤学瘤学.
- 皮肤病学 皮肤病学
- 免疫学 免疫学 免疫学
背景情况:
- 免疫检查点抑制剂 (ICI) 是重要的癌症治疗方法,但也可能导致牛皮.
- 使用全身药物 (saP) 治疗ICI诱导的牛皮引发了人们对ICI有效性降低的担忧.
- 有限的直接证据存在于管理ICI介导的牛皮 (ICI-Ps).
研究的目的:
- 为了解决管理ICI-Ps与saPs的临床问题.
- 评估saP对ICI疗效的影响.
- 为医疗保健专业人员和患者提供一个框架.
主要方法:
- 一个德尔菲过程,涉及15名国际皮肤病学,瘤学,免疫学和风湿病学专家.
- 系统的文献综述与基于推理的方法结合起来.
- 评估各种SAP,包括生物制剂,传统的全身疗法,小分子,视网体和皮质类固醇.
主要成果:
- 基于推断的结论是关于ICI-Ps使用saP的.
- 萨普对ICI疗效的潜在影响是主要关注的焦点.
- 制定了一个结构化的框架,以指导关于saP风险和好处的讨论.
结论:
- 治疗牛皮的全身性药物 (saPs) 可以用于ICI-Ps,而不会显著地降低ICI的有效性.
- 暂停ICI治疗通常不需要管理ICI-Ps.
- 如果可用,非类固醇SAPs应优先于全身性皮质类固醇.
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