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遗传性血管性水肿患者的疾病负担。

The burden of illness in patients with hereditary angioedema.

机构信息

Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Boston, Massachusetts.

出版信息

Ann Allergy Asthma Immunol. 2013 Nov;111(5):329-36. doi: 10.1016/j.anai.2013.08.019. Epub 2013 Sep 18.

Abstract

OBJECTIVE

Hereditary angioedema (HAE) is a rare genetic disease characterized by long-term recurrent attacks of subcutaneous or submucosal edema in different parts of the body. A comprehensive review of the literature on burden of illness for patients with HAE is presented.

DATA SOURCES

A Boolean search was performed using MEDLINE and EMBASE databases and the Internet.

STUDY SELECTION

Articles discussing aspects of the burden of illness in HAE were selected. Topics focused on the course of the disease, nature of attacks, treatment, quality of life, and costs.

RESULTS

Hereditary angioedema is associated with a significant and multifaceted disease burden. Diagnosis is often delayed for years, with patients receiving ineffective treatment and unnecessary medical procedures before diagnosis. HAE attacks are painful, unpredictable, and debilitating and often require emergency medical attention. Attacks can affect a patient's daily activities, including work or schooling. Depression and anxiety are prevalent in patients with HAE. Recent advances in treatment provide patients with effective and well-tolerated prophylactic and on-demand therapeutic options. However, end points specific to HAE that better measure the impact of treatment on disease burden are lacking. Furthermore, there is a notable paucity of literature directed toward physicians who are instrumental in diagnosing and treating patients with HAE (eg, emergency department).

CONCLUSION

More publications are broadening the understanding of HAE. However, important gaps remain. Effective management of HAE requires a more comprehensive understanding of the disease burden so that disease management can be individualized to meet specific patient needs.

摘要

目的

遗传性血管性水肿(HAE)是一种罕见的遗传性疾病,其特征是身体不同部位的皮下或粘膜下组织长期反复发作性水肿。本文对 HAE 患者疾病负担的文献进行了综合回顾。

资料来源

使用 MEDLINE 和 EMBASE 数据库以及互联网进行了布尔搜索。

研究选择

选择了讨论 HAE 疾病负担各个方面的文章。这些文章的主题集中在疾病的病程、发作的性质、治疗、生活质量和成本。

结果

遗传性血管性水肿与显著的多方面疾病负担有关。诊断通常需要多年时间,患者在诊断前接受无效治疗和不必要的医疗程序。HAE 发作疼痛、不可预测且使人虚弱,通常需要紧急医疗护理。发作会影响患者的日常活动,包括工作或上学。抑郁和焦虑在 HAE 患者中很常见。最近在治疗方面的进展为患者提供了有效且耐受性良好的预防和按需治疗选择。然而,缺乏专门针对 HAE 的终点,这些终点可以更好地衡量治疗对疾病负担的影响。此外,针对在诊断和治疗 HAE 患者方面发挥重要作用的医生(例如急诊科医生)的文献也明显不足。

结论

越来越多的出版物拓宽了对 HAE 的认识。然而,仍存在重要的差距。HAE 的有效管理需要更全面地了解疾病负担,以便能够根据特定患者的需求进行个体化的疾病管理。

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