德尔菲共识:第一线使用生物制剂和小分子在腹炎中
Georgios Nikolakis1,2,3,4, Erkan Alpsoy1,5, Florian Anzengruber1,6,7
1European Hidradenitis Suppurativa Foundation e.V, Dessau, Germany.
概括
专家建议早期使用生物药物或小分子治疗状腺炎 (HS),以防止痕. 这个这个这个这个这个
科学领域:
- 皮肤病学和免疫学
- 炎症性皮肤疾病是一种炎症性皮肤疾病.
- 治疗策略 治疗策略
背景情况:
- 补腺炎 (HS) 是一种慢性炎症性皮肤疾病,诊断的延迟和对生活质量的影响很大.
- 目前的指导方针经常建议使用抗生素作为一线治疗,但越来越需要更早地进行有针对性的干预,以防止疾病的进展和不可逆转的损害.
- 欧洲Hidradenitis Suppurativa基金会的目标是完善HS的治疗策略.
研究的目的:
- 建立专家的共识,对临床的标准,以启动第一线治疗生物药物和/或小分子在符合条件的hidradenitis suppurativa患者.
- 确定特定的患者亚组,他们可以从早期的向治疗中受益,以防止疾病的进展.
- 为了解决HS管理的临床实践和指导方针的制定.
主要方法:
- 一个德尔菲的共识过程,涉及54个来自欧洲的HS专家.
- 专家们对16项关于一线生物/小分子治疗标准的陈述进行了投票,使用利克尔特等级 (-5至+5).
- 确定了同意水平 (多数,共识,强烈共识),并根据临床相关性对陈述进行排名.
主要成果:
- 对于在抗生素禁用,快速进展和严重疾病患者中使用生物制剂/小分子获得了强烈的共识.
- 共识支持适度HS (IHS4 ≥4) 的早期向治疗,频繁的爆发,多个受影响的区域和特定的表型 (例如,生殖器).
- 强烈的共识也支持早期干预综合性HS和患有炎症性并发症 (IBD,关节炎) 的患者,包括患有家族病史和中度疾病的儿科病例.
结论:
- 这一共识提供了基于证据的标准,用于将HS患者升级为一线生物或小分子治疗.
- 这些发现支持一种"重创和早期"的方法,以尽量减少HS中痕和道形成.
- 这些由专家驱动的建议旨在使欧洲实践与更好的HS结果保持一致,等待前性研究的验证.
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