硫唑嘌呤治疗结缔组织病继发间质性肺疾病疗效观察研究

M. Saeidinejad, Sandosh Gnanalingam, A. Ashish
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引用次数: 0

摘要

硫唑嘌呤(Azathioprine, AZA)是治疗结缔组织病(CTD)相关间质性肺疾病(ILD)的常用药物,这在英国胸科学会2008年ILD指南中有所体现[1]。然而,这只是C级证据,并且没有研究报道该患者亚组的实际疗效。通过回顾性收集2010年1月至2018年12月在CTD - ILD诊所就诊的30例患者的数据,对AZA治疗CTD - ILD的有效性进行了观察性研究。患者的平均年龄为62.79 (+/- 13 SD)岁,其中16例(53%)为患有潜在CTDs的女性(表1)。16例(53%)患者持续AZA治疗的平均时间为52 (+/- 18 SD)个月。与未治疗组相比,该组的FVC和DLCO得以保留[平均FVC变化:-1.630% (CI 0.95 = 0.284) vs -15.767% (CI 0.95 = 0.555),平均DLCO变化:-4.478% (CI 0.95 = 0.302) vs -14.233% (CI 0.95 = 0.689)]。16例患者因毒性(16%)或不耐受性(27%)停用AZA。2名患者后来重新开始服用AZA,耐受性良好。我们的单中心经验表明,CTD相关ILD患者的FVC在平均50个月的AZA治疗期间保持稳定。这使我们得出结论,AZA对治疗CTD相关的ILD是有效的,但容易产生耐受性差和全身毒性。参考文献:[1]王晓明,王晓明。肺间质性疾病指南。胸。2008年9月1日;63(增刊5):v1-58。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
An observational study on effectiveness of azathioprine in treatment of interstitial lung disease secondary to connective tissue disease
Azathioprine (AZA) is common treatment for connective tissue disease (CTD) related interstitial lung disease (ILD) which is reflected in the British Thoracic Society 2008 ILD guideline [1]. However, this is only a grade C evidence and no studies have reported the real-life effectives in this patient subgroup. An observational study of the effectiveness of AZA in CTD ILD was carried out by retrospective data collection of 30 patients seen in CTD – ILD clinic between January 2010 and December 2018. The mean age of patients was 62.79 (+/- 13 SD) years of which 16 (53%) were females with underlying CTDs (table 1). 16 (53%) patients continued AZA for a mean duration of 52 (+/- 18 SD) months. The FVC and DLCO were preserved in this group compared to those who did not [Mean FVC change: -1.630% (CI 0.95 = 0.284) vs -15.767% (CI 0.95 = 0.555), Mean DLCO change: -4.478% (CI 0.95 = 0.302) vs -14.233% (CI 0.95 = 0.689) respectively]. AZA was stopped in 16 patients due to toxicity (16%) or intolerability (27%). 2 were later re-started on AZA with good tolerance. Our single centre experience showed that FVC of patients with CTD related ILD, over a mean 50-month duration of therapy with of AZA, remained stable. This leads us to conclude that AZA is effective in treatment of CTD related ILD but prone to poor tolerability and systemic toxicity. Reference: [1] Wells AU, Hirani N. Interstitial lung disease guideline. Thorax. 2008 Sep 1;63(Suppl 5):v1-58.
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