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3例黏膜类天疱疮患者使用依那西普治疗成功。

Successful treatment of mucous membrane pemphigoid with etanercept in 3 patients.

作者信息

Canizares Maria J, Smith David I, Conners Michael S, Maverick Kenneth J, Heffernan Michael P

机构信息

Division of Dermatology, Department of Ophthalmology, Washington University School of Medicine, St Louis, MO, USA.

出版信息

Arch Dermatol. 2006 Nov;142(11):1457-61. doi: 10.1001/archderm.142.11.1457.

Abstract

BACKGROUND

Mucous membrane pemphigoid (MMP), also known as cicatricial pemphigoid, is a serious, autoimmune, blistering disorder that can result in blindness and other complications as a result of scarring of the mucous membranes. Effective treatment modalities are often toxic. Herein, we describe a novel therapeutic approach that is based on 2 reports in the literature of the successful use of etanercept to treat MMP.

OBSERVATIONS

Three patients with MMP were treated with subcutaneous injections of 25 mg of etanercept twice weekly. All 3 patients had oral mucosal involvement, and 1 had severe, recalcitrant, ocular disease. Oral mucosal disease improved in all 3 patients. The patient with ocular involvement experienced stabilization of progression.

CONCLUSIONS

Effective treatment modalities for MMP are often toxic. Etanercept may be an effective treatment option for MMP of the oral and ocular mucous membranes. This therapy should be considered as an alternative treatment option for patients who would require other aggressive systemic treatments, such as cyclophosphamide, corticosteroids, azathioprine sodium, and intravenous immunoglobulin.

摘要

背景

黏膜类天疱疮(MMP),也称为瘢痕性类天疱疮,是一种严重的自身免疫性水疱性疾病,可因黏膜瘢痕形成导致失明及其他并发症。有效的治疗方式往往具有毒性。在此,我们基于文献中两例成功使用依那西普治疗MMP的报道,描述一种新的治疗方法。

观察结果

3例MMP患者接受皮下注射依那西普25mg,每周2次。所有3例患者均有口腔黏膜受累,1例患有严重、难治性眼部疾病。所有3例患者的口腔黏膜疾病均有改善。眼部受累患者的病情进展得到稳定。

结论

MMP的有效治疗方式往往具有毒性。依那西普可能是治疗口腔和眼部黏膜MMP的有效选择。对于需要其他积极全身治疗(如环磷酰胺、皮质类固醇、硫唑嘌呤钠和静脉注射免疫球蛋白)的患者,应考虑将这种治疗作为替代治疗选择。

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