阿那白滞素治疗难治性巩膜炎患者：一项初步研究。
Anakinra in the Treatment of Patients with Refractory Scleritis: A Pilot Study.
机构信息
a Department of Ophthalmology , Pitie-Salpetriere Hospital , Paris , France.
b Centre national de reference maladies oculaires inflammatoires rares, DHU vision et handicap , Universite Paris VI-Pierre et Marie Curie , Paris , France.
出版信息
Ocul Immunol Inflamm. 2018;26(6):915-920. doi: 10.1080/09273948.2017.1299869. Epub 2017 May 24.
PURPOSE
This study aimed to evaluate the safety and efficacy of anakinra for severe and refractory scleritis.
METHODS
Ten patients with severe (i.e. at least 2 ocular relapses per year despite treatment) and refractory [i.e. at least to one disease modifying antirheumatic drugs (DMARDS)] scleritis were treated with anakinra (100 mg/day subcutaneously). Scleritis was associated with inflammatory systemic diseases in 60% of cases. The remission rate defined the primary outcome.
RESULTS
Ninety percent of patients were complete responders with a mean follow-up of 19.4 months after starting anakinra. The corticosteroids daily dose decreased from 18.3 ± 4.1 mg to 4.2 ± 4.9 mg, (p < 0.05), at initiation of anakinra and at end of follow-up, respectively. Associated immunosuppressants were stopped in all cases except one. Side effects were observed in 4 patients who did not need anakinra withdrawal.
CONCLUSIONS
This pilot study suggests the efficacy of anakinra in patients with refractory scleritis.
目的
本研究旨在评估阿那白滞素治疗严重和难治性巩膜炎的安全性和疗效。
方法
10 名患有严重（即每年至少 2 次眼部复发，尽管进行了治疗）和难治性（即至少对一种疾病修正抗风湿药物（DMARDs））巩膜炎的患者接受了阿那白滞素（每天 100mg 皮下注射）治疗。60%的巩膜炎与炎症性系统性疾病有关。缓解率定义为主要结局。
结果
90%的患者为完全缓解者，在开始使用阿那白滞素后平均随访 19.4 个月。在开始使用阿那白滞素和随访结束时，皮质类固醇的日剂量分别从 18.3±4.1mg 降至 4.2±4.9mg（p<0.05）。除 1 例外，所有患者均停用了联合免疫抑制剂。4 名患者出现了副作用，但不需要停用阿那白滞素。
结论
这项初步研究表明阿那白滞素对难治性巩膜炎患者有效。
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