Griggs Robert C
Department of Neurology, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA.
Neurology. 2006 Jan 24;66(2 Suppl 1):S30-2. doi: 10.1212/01.wnl.0000192262.29924.9e.
There is no established treatment that improves, arrests, or slows the progression of inclusion-body myositis (IBM). Many anti-inflammatory, immunosuppressant, or immunomodulating agents have been administered to patients with IBM but the design of clinical trials was such that it can only be concluded that none produced rapid improvement. The natural history of the disease is for stabilization or improvement in a third of patients for 6 months or more. Thus some agents that did not produce dramatic benefit may have been prematurely abandoned. However, because high-dose prednisone worsens strength while decreasing inflammation but increases amyloid accumulation, alternative targets for intervention and novel treatment strategies are needed.
目前尚无已确立的治疗方法可改善、阻止或减缓包涵体肌炎(IBM)的进展。许多抗炎、免疫抑制或免疫调节药物已用于IBM患者,但临床试验的设计使得只能得出没有一种药物能带来快速改善的结论。该疾病的自然病程是三分之一的患者病情稳定或改善持续6个月或更长时间。因此,一些未产生显著益处的药物可能被过早放弃。然而,由于高剂量泼尼松在减轻炎症的同时会削弱肌力且增加淀粉样蛋白沉积,所以需要新的干预靶点和新型治疗策略。