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[糖皮质激素诱导的巨细胞动脉炎或风湿性多肌痛患者的不良事件]

[Glucocorticoid-induced adverse events in patients with giant cell arteritis or polymyalgia rheumatica].

作者信息

Fardet L

机构信息

Service de médecine interne, hôpital Saint-Antoine, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France.

出版信息

Rev Med Interne. 2013 Jul;34(7):438-43. doi: 10.1016/j.revmed.2013.02.031. Epub 2013 Jun 3.

Abstract

Giant cell arteritis and polymyalgia rheumatica are common reasons for prescribing long-term glucocorticoid therapy. Glucocorticoids efficacy in these patients is rapid and undeniable, but it is often overshadowed by adverse events, appearing more or less early during treatment course. These adverse events are usually minor but some of them may be life threatening. Because of the absence of randomized, controlled trials comparing glucocorticoids to placebo in this indication and in this aged population, it is difficult to precise the role of corticosteroids in the occurrence of some complications that can also be precipitated by the disease itself (e.g., vascular complications) or related to aging. In this context, analysis of the crude morbidity and mortality can help in anticipating the potential problems that these patients will encounter. In addition, the long duration of glucocorticoid exposure should prompt physicians to be particularly vigilant regarding some adverse events that are minimally symptomatic on the short term but have a major long-term impact.

摘要

巨细胞动脉炎和风湿性多肌痛是长期使用糖皮质激素治疗的常见原因。糖皮质激素在这些患者中的疗效迅速且无可否认,但它常常被不良事件所掩盖,这些不良事件在治疗过程中或多或少会较早出现。这些不良事件通常较为轻微,但其中一些可能危及生命。由于缺乏在该适应症和该老年人群中将糖皮质激素与安慰剂进行比较的随机对照试验,因此难以确切说明皮质类固醇在某些并发症发生中的作用,这些并发症也可能由疾病本身(如血管并发症)或与衰老相关的因素引发。在这种情况下,对粗发病率和死亡率的分析有助于预测这些患者可能遇到的潜在问题。此外,糖皮质激素暴露时间较长应促使医生对某些不良事件格外警惕,这些不良事件短期内症状轻微,但具有重大的长期影响。

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