Current Treatment Options in Rheumatology最新文献_第5页

Juvenile Dermatomyositis: New Clues to Diagnosis and Therapy. 幼年皮肌炎：诊断与治疗的新线索

Current Treatment Options in Rheumatology Pub Date : 2021-03-01 Epub Date: 2021-02-06 DOI: 10.1007/s40674-020-00168-5

Lauren M Pachman, Brian E Nolan, Deidre DeRanieri, Amer M Khojah

{"title":"Juvenile Dermatomyositis: New Clues to Diagnosis and Therapy.","authors":"Lauren M Pachman, Brian E Nolan, Deidre DeRanieri, Amer M Khojah","doi":"10.1007/s40674-020-00168-5","DOIUrl":"10.1007/s40674-020-00168-5","url":null,"abstract":"Purpose of review: To identify clues to disease activity and discuss therapy options.Recent findings: The diagnostic evaluation includes documenting symmetrical proximal muscle damage by exam and MRI, as well as elevated muscle enzymes-aldolase, creatine phosphokinase, LDH, and SGOT-which often normalize with a longer duration of untreated disease. Ultrasound identifies persistent, occult muscle inflammation. The myositis-specific antibodies (MSA) and myositis-associated antibodies (MAA) are associated with specific disease course variations. Anti-NXP-2 is found in younger children and is associated with calcinosis; anti-TIF-1γ+ juvenile dermatomyositis has a longer disease course. The diagnostic rash-involving the eyelids, hands, knees, face, and upper chest-is the most persistent symptom and is associated with microvascular compromise, reflected by loss of nailfold (periungual) end row capillaries. This loss is associated with decreased bioavailability of oral prednisone; the bioavailability of other orally administered medications should also be considered. At diagnosis, at least 3 days of intravenous methyl prednisolone may help control the HLA-restricted and type 1/2 interferon-driven inflammatory process. The requirement for avoidance of ultraviolet light exposure mandates vitamin D supplementation.Summary: This often chronic illness targets the cardiovascular system; mortality has decreased from 30 to 1-2% with corticosteroids. New serological biomarkers indicate occult inflammation: ↑CXCL-10 predicts a longer disease course. Some biologic therapies appear promising.","PeriodicalId":11096,"journal":{"name":"Current Treatment Options in Rheumatology","volume":"7 1","pages":"39-62"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8336914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39282552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Quantity and Quality of Rheumatoid Arthritis and Osteoarthritis Clinical Practice Guidelines: Systematic Review and Assessment Using AGREE II 类风湿关节炎和骨关节炎临床实践指南的数量和质量:使用AGREE II进行系统回顾和评估

Current Treatment Options in Rheumatology Pub Date : 2021-02-26 DOI: 10.1007/s40674-021-00172-3

J. Y. Ng, Ashlee M. Azizudin

引用次数: 3

Evaluation and Treatment of Pediatric Localized Scleroderma: Pearls and Updates 评价和治疗儿童局限性硬皮病:珍珠和更新

Current Treatment Options in Rheumatology Pub Date : 2021-02-13 DOI: 10.1007/s40674-021-00170-5

D. Glaser, K. Torok

引用次数: 1

Soluble Biomarkers for Prediction of Vascular and Gastrointestinal Disease Severity in Patients with Systemic Sclerosis 预测系统性硬化症患者血管和胃肠道疾病严重程度的可溶性生物标志物

Current Treatment Options in Rheumatology Pub Date : 2021-02-11 DOI: 10.1007/s40674-021-00171-4

Miruna Carnaru, M. Hinchcliff

引用次数: 0

In Pursuit of an Effective Treatment: the Past, Present and Future of Clinical Trials in Inclusion Body Myositis 追求有效治疗:包涵体肌炎临床试验的过去、现在和未来

Current Treatment Options in Rheumatology Pub Date : 2021-02-09 DOI: 10.1007/s40674-020-00169-4

A. Snedden, J. Lilleker, H. Chinoy

引用次数: 3

Non-infectious Chronic Uveitis in Childhood: Assessment and Treatment in the Biological Era 儿童非感染性慢性葡萄膜炎:生物学时代的评估与治疗

Current Treatment Options in Rheumatology Pub Date : 2021-01-06 DOI: 10.1007/s40674-020-00166-7

R. Ponti, M. Mastrolia, G. Simonini

引用次数: 0

Pharmacologic Treatment of Anti-MDA5 Rapidly Progressive Interstitial Lung Disease. 抗mda5快速进展间质性肺疾病的药物治疗。

Current Treatment Options in Rheumatology Pub Date : 2021-01-01 Epub Date: 2021-09-28 DOI: 10.1007/s40674-021-00186-x

A Selva-O'Callaghan, F Romero-Bueno, E Trallero-Araguás, A Gil-Vila, J C Ruiz-Rodríguez, O Sánchez-Pernaute, I Pinal-Fernández

{"title":"Pharmacologic Treatment of Anti-MDA5 Rapidly Progressive Interstitial Lung Disease.","authors":"A Selva-O'Callaghan, F Romero-Bueno, E Trallero-Araguás, A Gil-Vila, J C Ruiz-Rodríguez, O Sánchez-Pernaute, I Pinal-Fernández","doi":"10.1007/s40674-021-00186-x","DOIUrl":"https://doi.org/10.1007/s40674-021-00186-x","url":null,"abstract":"Purpose of the review: Idiopathic inflammatory myopathies are a heterogeneous group of autoimmune disorders. The presence of different autoantibodies allows clinicians to define distinct phenotypes. Antibodies against the melanoma differentiation-associated protein 5 gene, also called anti-MDA5 antibodies, are associated with a characteristic phenotype, the clinically amyopathic dermatomyositis with rapidly progressive interstitial lung disease. This review aims to analyze the different pharmacological options for the treatment of rapidly progressive interstitial lung disease in patients with anti-MDA5 antibodies.Recent findings: Evidence-based therapeutic recommendations suggest that the best initial approach to treat these patients is an early combination of immunosuppressive drugs including either glucocorticoids and calcineurin inhibitors or a triple therapy adding intravenous cyclophosphamide. Tofacitinib, a Janus kinase inhibitor, could be useful according to recent reports. High ferritin plasma levels, generalized worsening of pulmonary infiltrates, and ground-glass opacities should be considered predictive factors of a bad outcome. In this scenario, clinicians should consider rescue therapies such as therapeutic plasma exchange, polymyxin-B hemoperfusion, veno-venous extracorporeal membrane oxygenation, or even lung transplantation.Summary: Combined immunosuppressive treatment should be considered the first-line therapy for patients with anti-MDA5 rapidly progressive interstitial lung disease. Aggressive rescue therapies may be useful in refractory patients.","PeriodicalId":11096,"journal":{"name":"Current Treatment Options in Rheumatology","volume":" ","pages":"319-333"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8476986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39483078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 18

Rheumatoid arthritis-associated interstitial lung disease: Current update on prevalence, risk factors, and pharmacologic treatment. 类风湿关节炎相关间质性肺病:流行、危险因素和药物治疗的最新进展

Current Treatment Options in Rheumatology Pub Date : 2020-12-01 Epub Date: 2020-09-01 DOI: 10.1007/s40674-020-00160-z

Sicong Huang, Vanessa L Kronzer, Paul F Dellaripa, Kevin D Deane, Marcy B Bolster, Vivek Nagaraja, Dinesh Khanna, Tracy J Doyle, Jeffrey A Sparks

{"title":"Rheumatoid arthritis-associated interstitial lung disease: Current update on prevalence, risk factors, and pharmacologic treatment.","authors":"Sicong Huang, Vanessa L Kronzer, Paul F Dellaripa, Kevin D Deane, Marcy B Bolster, Vivek Nagaraja, Dinesh Khanna, Tracy J Doyle, Jeffrey A Sparks","doi":"10.1007/s40674-020-00160-z","DOIUrl":"https://doi.org/10.1007/s40674-020-00160-z","url":null,"abstract":"Purpose of review: Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) is one of the most serious extra-articular RA manifestations. RA-ILD is associated with worse physical function, lower quality of life, and increased mortality. RA-ILD is comprised of heterogeneous subtypes characterized by inflammation and fibrosis. Diagnosis can be difficult since the presentation of RA-ILD is characterized by non-specific symptoms and imaging findings. Management of RA-ILD is also challenging due to difficulty in precisely measuring pulmonary disease activity and response to treatment in patients who may also have articular inflammation. We provide a current overview of RA-ILD focusing on prevalence, risk factors, and treatment.Recent findings: Research interest in RA-ILD has increased in recent years. Some studies suggest that RA-ILD prevalence may be increasing; this may be due to underlying biologic drivers or increases in imaging and recognition. Novel RA-ILD risk factors include the MUC5B promotor variant, articular disease activity, autoantibodies, and biomarkers of damaged pulmonary parenchyma. Treatment should focus on controlling RA disease activity, which emerging data suggest may reduce RA-ILD risk. Immunomodulatory and antifibrotic drugs may also treat RA-ILD.Summary: RA-ILD is an underrecognized and serious manifestation of RA, but important progress is being made in identifying risk factors and treatment.","PeriodicalId":11096,"journal":{"name":"Current Treatment Options in Rheumatology","volume":"6 4","pages":"337-353"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s40674-020-00160-z","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38341048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 30

An Update on Imaging in Rheumatoid Arthritis 类风湿关节炎影像学研究进展

Current Treatment Options in Rheumatology Pub Date : 2020-11-13 DOI: 10.1007/s40674-020-00165-8

M. Isbel, S. Paramalingam, P. Conaghan, H. Keen

引用次数: 2

Current Therapeutic Approaches in Scleroderma: Clinical Models of Effective Antifibrotic Therapies 当前硬皮病的治疗方法:有效抗纤维化治疗的临床模型

Current Treatment Options in Rheumatology Pub Date : 2020-11-08 DOI: 10.1007/s40674-020-00164-9

S. Johnson, D. Furst

引用次数: 1