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治疗型硬化症:当更少是更多的时候,更少是更多.

Niamh Logan1, Jessica Raja1, Elisabetta A Renzoni2

  • 1Department of Interstitial Lung Diseases, Royal Brompton Hospital, Dovehouse St, London SW36JY, UK.

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概括

Sarcoidosis 管理正在从长时间的高剂量类固醇转变为长期的高剂量类固醇.

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科学领域:

  • 免疫学 免疫学 免疫学
  • 类风湿病学 类风湿病学
  • 神经学 神经学

背景情况:

  • Sarcoidosis 呈现异质,从自发缓解到神经病变和疲劳等致残症状.
  • 危及器官或危及生命的类瘤需要修改疾病的疗法.
  • 传统的葡萄糖皮质醇使用受到毒性担忧的挑战.

研究的目的:

  • 审查当前的沙尔科毒症治疗策略.
  • 为了突出转向减少类固醇使用的范式转变.
  • 讨论替代性和基于症状的治疗方法.

主要方法:

  • 关于当前的沙尔科毒症治疗的文献综述.
  • 对最近的临床试验数据的分析.
  • 专注于节制葡萄糖皮质激素的策略.

主要成果:

  • 甲托雷克萨特在肺部型硬化症中显示出与葡萄糖皮质类药物相似的疗效,尽管效果延迟.
  • 与葡萄糖皮质醇相关的毒性证据越来越多.
  • "少就是多"的方法正在获得引力.

结论:

  • 治疗策略正在不断发展,以尽量减少类固醇毒性.
  • 基于症状的管理对于不响应的表现至关重要.
  • 未来的肉增生症治疗强调量身定制的,少有毒的方法.