[日本沙利度胺治疗麻风结节性红斑的指南]

[Japanese guideline on thalidomide usage in the management of erythema nodosum leprosum].

作者信息

Ishii Norihisa, Ishida Yutaka, Okano Yoshiko, Ozaki Motoaki, Gidoh Masaich, Kumano Kimiko, Goto Masamichi, Nogami Reiko, Hatano Kentaro, Yamada Akatsuki, Yotsu Rie Roselyne

机构信息

Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan.

出版信息

Nihon Hansenbyo Gakkai Zasshi. 2011 Sep;80(3):275-85. doi: 10.5025/hansen.80.275.

DOI:10.5025/hansen.80.275

PMID:21941834

Abstract

Treatment of erythema nodosum leprosum (ENL, type 2 reaction) using thalidomide provides effective alternative choice to steroid therapy. Yet, the Japanese National Health Insurance approves thalidomide prescription only for the treatment of multiple myeloma under the Thalidomide Education and Risk Management System (TERMS). Benefit of thalidomide therapy for patients with ENL is already an established fact based on various reports from other countries, but limited experiences and standards in Japan have hindered application of the medication to our patients. This led us to compose a local guideline. Based on and following the TERMS, we suggest starting thalidomide from 50-100 mg/day and then onwards adjusting the dose according to the symptoms of each patient, not to exceed the maximum recommended dose of 300 mg/day, for the treatment of ENL.

摘要

使用沙利度胺治疗麻风结节性红斑（ENL，2型反应）为类固醇疗法提供了有效的替代选择。然而，日本国民健康保险仅在沙利度胺教育与风险管理系统（TERMS）下批准沙利度胺处方用于治疗多发性骨髓瘤。基于其他国家的各种报告，沙利度胺治疗ENL患者的益处已是既定事实，但日本有限的经验和标准阻碍了该药物在我们患者中的应用。这促使我们制定了一份本地指南。基于并遵循TERMS，我们建议治疗ENL时，从50-100毫克/天开始使用沙利度胺，然后根据每位患者的症状调整剂量，不超过300毫克/天的最大推荐剂量。