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重症肌无力的治疗

Treatment of Myasthenia Gravis.

作者信息

Farmakidis Constantine, Pasnoor Mamatha, Dimachkie Mazen M, Barohn Richard J

机构信息

Department of Neurology, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mail Stop 2012, Kansas City, KS 66160, USA.

Department of Neurology, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mail Stop 2012, Kansas City, KS 66160, USA.

出版信息

Neurol Clin. 2018 May;36(2):311-337. doi: 10.1016/j.ncl.2018.01.011.

Abstract

With specialized care, patients with myasthenia gravis can have very good outcomes. The mainstays of treatment are acetylcholinesterase inhibitors, and immunosuppressive and immunomodulatory therapies. There is good evidence thymectomy is beneficial in thymomatous and nonthymomatous disease. Nearly all of the drugs used for MG are considered "off-label." The 2 exceptions are acetylcholinesterase inhibitors and complement inhibition with eculizumab, which was recently approved by the US Food and Drug Administration for myasthenia gravis. This article reviews the evidence base and provides a framework for the treatment of myasthenia gravis, highlighting recent additions to the literature.

摘要

通过专业护理,重症肌无力患者可以获得非常好的治疗效果。治疗的主要手段是乙酰胆碱酯酶抑制剂、免疫抑制和免疫调节疗法。有充分证据表明胸腺切除术对胸腺瘤型和非胸腺瘤型疾病有益。几乎所有用于重症肌无力的药物都属于“超说明书用药”。两个例外是乙酰胆碱酯酶抑制剂和使用依库珠单抗进行补体抑制,依库珠单抗最近被美国食品药品监督管理局批准用于治疗重症肌无力。本文回顾了证据基础,并提供了一个重症肌无力治疗框架,重点介绍了近期文献中的新增内容。

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