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自身炎症性疾病管理建议。

Recommendations for the management of autoinflammatory diseases.

机构信息

Laboratory for Translational Immunology, University Medical Center Utrecht, Utrecht, Netherlands Department of Paediatric Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.

Division of Paediatric Rheumatology, University Hospital Tuebingen, Tuebingen, Germany.

出版信息

Ann Rheum Dis. 2015 Sep;74(9):1636-44. doi: 10.1136/annrheumdis-2015-207546. Epub 2015 Jun 24.

DOI:
10.1136/annrheumdis-2015-207546
PMID:26109736
Abstract

: Autoinflammatory diseases are characterised by fever and systemic inflammation, with potentially serious complications. Owing to the rarity of these diseases, evidence-based guidelines are lacking. In 2012, the European project Single Hub and Access point for paediatric Rheumatology in Europe (SHARE) was launched to optimise and disseminate regimens for the management of children and young adults with rheumatic diseases, facilitating the clinical practice of paediatricians and (paediatric) rheumatologists. One of the aims of SHARE was to provide evidence-based recommendations for the management of the autoinflammatory diseases cryopyrin-associated periodic syndromes (CAPS), tumour necrosis factor (TNF) receptor-associated periodic syndrome (TRAPS) and mevalonate kinase deficiency (MKD). These recommendations were developed using the European League Against Rheumatism standard operating procedure. An expert committee of paediatric and adult rheumatologists was convened. Recommendations derived from the systematic literature review were evaluated by an online survey and subsequently discussed at a consensus meeting using Nominal Group Technique. Recommendations were accepted if more than 80% agreement was reached. In total, four overarching principles, 20 recommendations on therapy and 14 recommendations on monitoring were accepted with ≥80% agreement among the experts. Topics included (but were not limited to) validated disease activity scores, therapy and items to assess in monitoring of a patient. By developing these recommendations, we aim to optimise the management of patients with CAPS, TRAPS and MKD.

摘要

自身炎症性疾病的特征是发热和全身炎症,可能伴有严重的并发症。由于这些疾病较为罕见,因此缺乏基于证据的指南。2012 年,启动了欧洲项目“欧洲儿科风湿病学单一枢纽和接入点(SHARE)”,旨在优化和传播儿童和青年风湿性疾病管理方案,促进儿科医生和(儿科)风湿病学家的临床实践。SHARE 的目标之一是为自身炎症性疾病 Cryopyrin 相关周期性综合征(CAPS)、肿瘤坏死因子(TNF)受体相关周期性综合征(TRAPS)和甲羟戊酸激酶缺乏症(MKD)的管理提供基于证据的建议。这些建议是使用欧洲抗风湿病联盟标准操作程序制定的。召集了一组儿科和成人风湿病专家组成的专家委员会。从系统文献综述中得出的建议通过在线调查进行评估,然后使用名义群体技术在共识会议上进行讨论。如果达成 80%以上的共识,则接受建议。总共接受了四项总体原则、20 项治疗建议和 14 项监测建议,专家组达成了 80%以上的一致。这些建议涉及(但不限于)经过验证的疾病活动评分、治疗以及监测患者时需要评估的项目。通过制定这些建议,我们旨在优化 CAPS、TRAPS 和 MKD 患者的管理。

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