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在葡萄膜炎治疗中生物反应调节剂的理解与应用进展。

Progress in the understanding and utilization of biologic response modifiers in the treatment of uveitis.

作者信息

Maleki Arash, Meese Halea, Sahawneh Haitham, Foster C Stephen

机构信息

a Massachusetts Eye Research and Surgery Institution , Waltham , MA , USA.

b Ocular Immunology & Uveitis Foundation , Waltham , MA , USA.

出版信息

Expert Rev Clin Immunol. 2016 Jul;12(7):775-86. doi: 10.1586/1744666X.2016.1166052. Epub 2016 Mar 29.

Abstract

Uveitis is the third most common cause of blindness in developed countries. Considering the systemic and local complications of long-term corticosteroid therapy and the intolerance due to side effects and ineffectiveness of conventional chemotherapy, use of biologic response modifiers is a reasonable alternative in the treatment of non-infectious uveitis and persistent uveitic macular edema. The majority of the evidence presented here comes from open uncontrolled analyses. Based on these studies, tumor necrosis factor alpha inhibitors, especially infliximab and adalimumab, have been shown to be effective in the treatment of non-infectious uveitis in numerous studies. More research is necessary, particularly multi-center randomized clinical trials, to address the choice of biologic response modifier agent and the length of treatment as we employ biologic response modifiers in different types of uveitis and persistent uveitic macular edema.

摘要

葡萄膜炎是发达国家中导致失明的第三大常见病因。考虑到长期使用皮质类固醇疗法的全身和局部并发症,以及传统化疗因副作用和无效性导致的不耐受情况,使用生物反应调节剂是治疗非感染性葡萄膜炎和持续性葡萄膜炎性黄斑水肿的合理选择。此处呈现的大多数证据来自开放性非对照分析。基于这些研究,肿瘤坏死因子α抑制剂,尤其是英夫利昔单抗和阿达木单抗,在众多研究中已显示出对治疗非感染性葡萄膜炎有效。随着我们在不同类型的葡萄膜炎和持续性葡萄膜炎性黄斑水肿中应用生物反应调节剂,需要进行更多研究,尤其是多中心随机临床试验,以解决生物反应调节剂药物的选择和治疗时长问题。

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