系统性皮质类固醇的负担在慢性鼻炎患者与鼻的息肉
Anju T Peters1, Jayant M Pinto2, Kathleen M Buchheit3
1From the Allergy-Immunology Division and the Sinus and Allergy Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
系统性皮质类固醇 (SCS) 提供慢性鼻炎与鼻息肉 (CRSwNP) 的短期缓解症状,但具有重大风险. 生物制品可能提供更安全的替代品,可能减少对SCS的依赖.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 当一线治疗失败时,常常需要全身皮质类固醇 (SCS) 治疗的慢性鼻炎与鼻息肉 (CRSwNP).
- 对长期使用SCS的不良影响的担忧正在促使管理策略发生转变.
- 生物疗法的出现正在影响SCS在CRSwNP治疗中的既定作用.
研究的目的:
- 审查系统性皮质类固醇 (SCS) 在治疗带鼻息肉的慢性鼻炎 (CRSwNP) 中的当前作用.
- 在不断发展的CRSwNP治疗选择的背景下评估SCS使用,包括生物药物.
- 在CRSwNP管理中评估与SCS相关的好处和风险.
主要方法:
- 进行了全面的文献搜索.
- 包括有关关于CRSwNP的全身皮质类固醇的相关文章和临床指南.
- 专注于评估SCS疗效,不良影响和新疗法影响的研究.
主要成果:
- 短暂的SCS疗程可以在CRSwNP中提供暂时的症状改善和息肉大小的减少.
- SCS用于内镜鼻手术的外科手术,尽管术后益处缺乏确的证据.
- SCS的显著不良影响包括血管亡,感染,代谢和精神问题.
- 目前的SCS剂量和CRSwNP的指导方针定义不完善,导致实践变化.
- 生物学表明类固醇节约作用,有可能减少SCS使用.
结论:
- 在CRSwNP中短期使用SCS需要仔细考虑潜在的不良影响.
- 生物疗法在减少CRSwNP中SCS的需求方面表现有前途,从而减轻相关风险.
- 将SCS的好处与风险进行平衡至关重要,特别是随着生物制剂的出现.
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