霉酚酸酯治疗原发性中枢神经系统血管炎。
Mycophenolate mofetil in primary central nervous system vasculitis.
机构信息
Unitá Operativa di Reumatologia, Azienda Ospedaliera-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
Department of Neurology, Mayo Clinic, Rochester, MN.
出版信息
Semin Arthritis Rheum. 2015 Aug;45(1):55-9. doi: 10.1016/j.semarthrit.2015.02.008. Epub 2015 Feb 20.
OBJECTIVE
To evaluate the efficacy and safety of mycophenolate mofetil (MMF) in adult primary central nervous system vasculitis (PCNSV).
METHODS
We studied a cohort of 163 patients with PCNSV who were seen at the Mayo Clinic from 1983 to 2011. We compared patients treated with MMF and those receiving other therapies.
RESULTS
We identified 16 patients treated with MMF. MMF in combination with GCs achieved a favorable response in most patients. A significant proportion of patients treated with MMF had a less severe disability at last follow-up compared to those receiving other therapies (p = 0.023) and cyclophosphamide and prednisone (p = 0.017). No statistically significant differences were observed regarding relapses and ability to discontinue therapy at last follow-up. A trend to a more favorable treatment response was observed in patients treated with MMF compared to those treated with other therapies (p = 0.075). Only 1 patient suspended MMF for severe leukopenia.
CONCLUSION
MMF seems to be an effective and safe therapy for adult PCNSV.
目的
评估霉酚酸酯（MMF）治疗成人原发性中枢神经系统血管炎（PCNSV）的疗效和安全性。
方法
我们研究了 1983 年至 2011 年在梅奥诊所就诊的 163 例 PCNSV 患者。我们比较了接受 MMF 治疗和其他治疗的患者。
结果
我们确定了 16 例接受 MMF 治疗的患者。MMF 联合 GCs 使大多数患者获得了良好的反应。与接受其他治疗（p=0.023）和环磷酰胺联合泼尼松治疗的患者相比，接受 MMF 治疗的患者在最后一次随访时的残疾程度较轻（p=0.017）。在最后一次随访时，关于复发和停药的能力，没有观察到统计学上的显著差异。与接受其他治疗的患者相比，接受 MMF 治疗的患者的治疗反应更有优势（p=0.075）。仅有 1 例患者因严重白细胞减少而停用 MMF。
结论
MMF 似乎是治疗成人 PCNSV 的一种有效且安全的治疗方法。
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