Medscape:2011受关注风湿病进展

2012-01-25 MedSci MedSci原创

2011年风湿病最受关注的10个问题和新闻如下:   1. 风湿科医师执业情况调查   2.环磷酰胺已确定是治疗系统性硬化病严重表现的一种潜在方法,但药物疗效缺乏持久性,不超过18个月。另外,环磷酰胺也能稳定那些患有严重肺纤维化的患者的病情。   3.抗血管紧张素Ⅱ1型受体和内皮素-1A型受体的自身抗体在系统性硬化病患者中有较高的流行率,它们可能是疾病的发病机制,并且可能是系统性硬

2011年风湿病最受关注的10个问题和新闻如下:

  1. 风湿科医师执业情况调查

  2.环磷酰胺已确定是治疗系统性硬化病严重表现的一种潜在方法,但药物疗效缺乏持久性,不超过18个月。另外,环磷酰胺也能稳定那些患有严重肺纤维化的患者的病情。

  3.抗血管紧张素Ⅱ1型受体和内皮素-1A型受体的自身抗体在系统性硬化病患者中有较高的流行率,它们可能是疾病的发病机制,并且可能是系统性硬化病血管并发症的预测危险因子。

  4.TNF抑制剂因2种细菌—军团病杆菌属和利斯特菌病感染加黑框警告

  5. 一项纳入有痛风史和尿酸≥ 8.0 mg/dL3609例患者的Ⅲ期研究表明,非布司他安全性与别嘌醇相当;且对于有轻中度肾病损患者来说,任何剂量的非布司他在降低尿酸水平上都优于别嘌醇。

  6. 在风湿性多肌痛患者中,泼尼松起始剂量取决于体重

  7.贝利木单抗是FDA首个批准治疗系统性红斑狼疮的药物,是针对B细胞存活因子BLyS的抗体。批准该药用于治疗有系统性红斑狼疮、自身抗体且疾病处于活动期的患者,只用于成人,因为在儿童中未进行临床研究。研究者认为,SLE活动期累及血液系统、浆膜炎和关节炎的患者,可作为贝利木单抗的先行使用者。由于未经过研究,该药目前不应用于患有狼疮肾炎或活动性中枢神经系统疾病的患者,或与其他生物制剂合用。

  8.深入了解纤维肌痛

  9.培化舍珠单抗是一种新的聚乙二醇抗TNF的生物制剂,批准用于治疗成人中重度活动性类风湿关节炎(RA)。临床试验证实,培化舍珠单抗联合甲氨蝶呤或单一疗法治疗1周就能改善类风湿关节炎患者的体征和症状,治疗16周抑制关节结构性损害。培化舍珠单抗耐受性良好、安全性与其他抗TNF抑制剂相似,注射痛发生率低。

  10.一项24周随机三盲安慰剂对照试验研究表明,多西环素在改善膝关节骨性关节炎疼痛和功能上并不优于安慰剂。研究中,多西环素治疗组患者因出现日光敏感、腹泻等常见不良反应而停药。研究者认为,尽管多西环素通过抑制软骨降解酶改善关节炎器质性病变,但短期改善骨关节炎疼痛期望不大。

  相关链接:Top Ten Rheumatology Articles of 2011

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    2012-06-29 smlt2008
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    2012-07-22 feather89
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    2012-01-27 zhaojie88
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