改变治疗模式对系统性硬化症间歇性肺病进展的影响,使用EUSTAR数据库
Corrado Campochiaro1, Marie-Elise Truchetet2, Madelon Vonk3
1Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), Inflammation, fibrosis and ageing Initiative (INFLAGE), IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy.
Arthritis & rheumatology (Hoboken, N.J.)
|January 22, 2026
概括
系统性硬化症相关的间歇性肺病 (SSc-ILD) 的治疗已经进化,免疫抑制疗法 (IST) 的使用增加. 尽管取得了进展,但疾病的进展仍在持续,这凸显了对新型治疗方法的需求.
科学领域:
- 类风湿病学 类风湿病学
- 肺部病理学 肺部病理学
- 临床药理学 临床药理学
背景情况:
- 系统性硬化症相关的间歇性肺病 (SSc-ILD) 治疗已经发展成为新的免疫抑制 (IST) 和抗纤维性疗法.
- 这些疗法在SSc-ILD中的真实世界利用模式仍然不完全理解.
研究的目的:
- 分析SSc-ILD治疗策略的时间趋势.
- 通过EUSTAR数据库评估IST和抗纤维治疗对ILD进展的影响.
主要方法:
- 来自EUSTAR数据库 (n=1,409) 满足2013年ACR/EULAR标准的SSc-ILD患者的回顾性分析.
- 患者被分为四个时间段 (≤2006,2007-2011,2012-2016,≥2017) 来评估IST启动,切换,停止和组合治疗.
- 在12个月内,ILD进展定义为%FVC下降≥5%或%DLCO下降≥10%.
主要成果:
- 传染病使用率显著增加,从13.6%增加到57.4% (p<0.001),其中甲酸莫菲蒂尔成为最常见的传染病.
- 联合治疗使用率从17.9%上升到26.9% (p<0.001),而ILD进展率从21.3%下降到12.1% (p<0.001).
- 与治疗开始相关的因素包括较短的疾病持续时间和肌肉炎;切换与较高的mRSS和关节炎有关.
结论:
- 对SSc-ILD的临床实践已经显著发展,以增加IST利用率和组合疗法为标志.
- 尽管治疗取得了进展,但很大一部分患者继续出现疾病进展,这强调了需要更有效的治疗策略.
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