[大血管炎治疗新闻]。

IF 0.9 4区 医学 Q4 RHEUMATOLOGY
Nils Venhoff, Markus Zeisbrich
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引用次数: 0

摘要

大血管脉管炎,如巨细胞动脉炎(GCA)和高安动脉炎(TAK),主要表现在大中型动脉上。巨细胞动脉炎主要影响 60 岁以后的老年人,而高安动脉炎主要影响 40 岁以下的年轻女性。糖皮质激素(GC)仍然是治疗这两种疾病的标准药物。特别是难治性病程和复发往往需要长期使用大剂量的糖皮质激素,这会导致发病率和死亡率上升。迄今为止,只有白细胞介素 6(IL-6)受体阻断剂托西珠单抗被批准用于治疗 GCA。有关甲氨蝶呤和其他常规免疫抑制剂的数据并不完整,有时甚至相互矛盾。尽管随机安慰剂对照试验的数量有限,而且目前还没有一种节省类固醇的治疗方法被批准用于治疗TAK,但还是建议TAK患者尽早使用节省类固醇的免疫抑制剂。对于这两种疾病,我们仍然亟需能够有效治疗脉管炎、预防损害并进行充分疾病监测的现代、安全的类固醇保留治疗。本文概述了 GCA 和 TAK 的研究现状和未来可能的治疗方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[News on the treatment of large vessel vasculitis].

Large vessel vasculitis, such as giant cell arteritis (GCA) and Takayasu arteritis (TAK) are primarily manifested on large and medium-sized arteries. While GCA mainly affects older people after the 6th decade of life onwards, TAK mainly affects young women under the age of 40 years. Glucocorticoids (GC) are still the standard treatment for both diseases. Refractory courses and relapses in particular often lead to long-term treatment with high cumulative doses of GC, which can lead to increased morbidity and mortality. To date, only the interleukin 6 (IL-6) receptor blocker tocilizumab has been approved for the treatment of GCA. The data on methotrexate and other conventional immunosuppressants are incomplete and in some cases contradictory. The early use of steroid-sparing immunosuppressants is recommended for TAK, although the number of randomized placebo-controlled trials is limited and no steroid-sparing treatment has yet been approved for TAK. For both diseases there is still a great need for modern and safe steroid-sparing treatment that effectively treats vasculitis, prevents damage and enables adequate disease monitoring. This article provides an overview of the current study situation and possible future treatment options for GCA and TAK.

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来源期刊
Zeitschrift fur Rheumatologie
Zeitschrift fur Rheumatologie 医学-风湿病学
CiteScore
2.20
自引率
20.00%
发文量
150
审稿时长
6-12 weeks
期刊介绍: Die Zeitschrift für Rheumatologie ist ein international angesehenes Publikationsorgan und dient der Fortbildung von niedergelassenen und in der Klinik tätigen Rheumatologen. Die Zeitschrift widmet sich allen Aspekten der klinischen Rheumatologie, der Therapie rheumatischer Erkrankungen sowie der rheumatologischen Grundlagenforschung. Umfassende Übersichtsarbeiten zu einem aktuellen Schwerpunktthema sind das Kernstück jeder Ausgabe. Im Mittelpunkt steht dabei gesichertes Wissen zu Diagnostik und Therapie mit hoher Relevanz für die tägliche Arbeit – der Leser erhält konkrete Handlungsempfehlungen. Frei eingereichte Originalien ermöglichen die Präsentation wichtiger klinischer Studien und dienen dem wissenschaftlichen Austausch.
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