肾小球疾病的治疗负担:免疫抑制治疗的进展和挑战。

Frontiers in nephrology Pub Date : 2025-05-01 eCollection Date: 2025-01-01 DOI:10.3389/fneph.2025.1545373
Mythri Shankar, Tanuj Moses Lamech
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摘要

肾小球疾病是一项重大的全球健康挑战,其治疗所需的复杂管理使其复杂化。我们研究了与用于治疗这些疾病的免疫抑制疗法相关的治疗负担,重点关注糖皮质激素、霉酚酸酯(MMF)、环磷酰胺、钙调磷酸酶抑制剂和利妥昔单抗等常用药物的疗效、副作用和财务影响。免疫抑制治疗虽然在控制疾病活动方面有效,但可能导致各种不良反应,从胃肠道症状和骨髓抑制到增加感染风险,需要仔细监测和调整剂量以减轻这些风险。因此,需要在治疗管理中采取平衡的方法,包括定期监测和潜在的剂量调整,以提高患者的预后,同时最大限度地减少副作用。此外,这些治疗具有经济影响,特别是在获得药物和药物费用可能限制患者预后的低收入地区。治疗方式已经取得了一定的进步,例如使用肠溶包衣配方和量身定制的给药方案,旨在提高药物耐受性和依从性。通过解决这些关键方面,我们的目标是阐明肾小球疾病管理的持续挑战和发展,强调需要继续研究和创新治疗策略,以减轻总体治疗负担,提高患者的生活质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Treatment burden in glomerular diseases: advances and challenges in immunosuppressive therapy.

Glomerular diseases represent a significant global health challenge, complicated by the intricate management required for their treatment. We examine the treatment burden associated with the immunosuppressive therapies used to manage these conditions, focusing on the efficacy, side effects, and financial implications of commonly used medications such as glucocorticoids, mycophenolate mofetil (MMF), cyclophosphamide, calcineurin inhibitors and Rituximab. Immunosuppressive treatments, while effective in controlling disease activity, can result in a variety of adverse effects ranging from gastrointestinal symptoms and bone marrow suppression to increased infection risks, necessitating careful monitoring and dose adjustments to mitigate these risks. Hence, the need for a balanced approach in therapy management, incorporating regular monitoring and potential dose modifications to enhance patient outcomes while minimizing side effects. Additionally, these treatments have an economic impact, particularly in lower-income regions where access to medication and the cost of medication can limit patient outcomes. There have been certain advancements in treatment modalities, such as the use of enteric-coated formulations and tailored dosing schedules, which aim to improve drug tolerability and adherence. By addressing these critical aspects, we aim to shed light on the ongoing challenges and developments in the management of glomerular diseases, emphasizing the need for continued research and innovation in therapeutic strategies to reduce the overall treatment burden and improve the quality of life for affected individuals.

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