针对性免疫抑制和免疫调节疗法用于异常性炎症性肌肉病变
Joost Raaphorst1, Nicola J Gullick2,3,4, Farhad Shokraneh5,6,7,8,9
1Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.
The Cochrane database of systematic reviews
|August 1, 2025
概括
目前针对异常性炎症性肌肉病 (IIM) 的治疗方法缺乏强有力的证据. 虽然阿巴切在达到改善标准方面可能会带来一些好处,但利图西马布,阿巴切和补充抑制剂的整体证据仍然不确定,需要进一步研究.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 神经学 神经学
背景情况:
- 异形性炎症性肌肉病 (IIM) 是一种影响骨肌肉的自身免疫性疾病.
- 对于IIM的现有治疗方法,其使用指导的证据有限.
- 目前正在研究针对B细胞,T细胞和补充通路的新疗法.
研究的目的:
- 评估针对各种IIM亚型的向免疫抑制和免疫调节治疗的益处和危害.
- 为了评估治疗方法,包括利图西马布,阿巴塞普特和补充抑制剂.
- 为IIM管理综合随机对照试验 (RCT) 的证据.
主要方法:
- 搜索了多个数据库和临床试验注册到2023年2月.
- 包括针对成人和儿童IIM的向治疗的RCT和准RCT.
- 评估了功能,残疾和肌肉力量的初级结果,二级结果包括不良事件和疾病活动措施.
主要成果:
- 包括16项研究 (830名参与者),所有这些都存在一些偏差风险.
- 与安慰剂相比,没有一种治疗方法显示出对主要或次要结果的中度或高确定性证据.
- 阿巴切显示了低确定性证据,证明了残疾的潜在改善,并实现了国际肌炎评估和临床研究小组 (IMACS) 的改善定义.
结论:
- 在IIM中,Rituximab,Abatacept和补充抑制剂的证据在很大程度上是不确定的.
- 阿巴塞普特可能在实现特定改善标准方面提供一些好处,但确定性很低.
- 需要进一步的大型多中心试验来确定IIM中这些向治疗的疗效和安全性.
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