关于在原发性干燥综合征中使用生物药物的SER建议。
SER recommendations on the use of biological drugs in primary Sjögren's syndrome.
作者信息
Andréu Sánchez José Luis, Fernández Castro Mónica, Del Campo Fontecha Petra Díaz, Corominas Héctor, Narváez García Francisco Javier, Gómez de Salazar José Rosas, Rua-Figueroa Íñigo, Abad Hernández Miguel Ángel, Álvarez Rivas María Noelia, Montes Javier Del Pino, Francisco Hernández Félix Manuel, Gantes Pedraza María Ángeles, Greco Merino Martín Gerardo, Hernández María Vanesa, Navarro Compán María Victoria, Solarte Juan Alberto Paz, Romero Bueno Fredeswinda I, Park Hye Sang, Sivera Mascaró Francisca
机构信息
Servicio de Reumatología, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Madrid, España.
Servicio de Reumatología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, España.
出版信息
Reumatol Clin (Engl Ed). 2019 Nov-Dec;15(6):315-326. doi: 10.1016/j.reuma.2018.10.014. Epub 2019 Jan 23.
OBJECTIVE
To formulate SER recommendations for the use of biological agents in primary Sjögren's syndrome (pSS).
METHODS
Relevant clinical research questions were identified on the use of biological agents in pSS. The clinical questions were reformulated into 4PICO questions. A search strategy was designed and a review of the scientific evidence of studies published until May 2017 was carried out. The scientific evidence available was systematically reviewed. The overall level of scientific evidence was assessed using the SIGN evidence levels. After that, specific recommendations were made.
RESULTS
Rituximab is recommended as the biological agent of choice for extraglandular manifestations refractory to conventional treatment. The use of anti-TNF agents is discouraged. The scientific evidence with belimumab and abatacept is scarce, so they should be considered only in cases refractory to rituximab.
CONCLUSIONS
Rituximab is the biological agent of choice in severe extraglandular manifestations of pSS. Belimumab or abatacept may be useful in selected cases.
目的
制定关于在原发性干燥综合征（pSS）中使用生物制剂的SER建议。
方法
确定了有关在pSS中使用生物制剂的相关临床研究问题。将临床问题重新表述为4个PICO问题。设计了检索策略，并对截至2017年5月发表的研究的科学证据进行了综述。对现有的科学证据进行了系统评价。使用SIGN证据等级评估科学证据的总体水平。此后，提出了具体建议。
结果
推荐利妥昔单抗作为对传统治疗难治的腺体外表现的首选生物制剂。不鼓励使用抗TNF药物。贝利尤单抗和阿巴西普的科学证据较少，因此仅应在对利妥昔单抗难治的病例中考虑使用它们。
结论
利妥昔单抗是pSS严重腺体外表现的首选生物制剂。贝利尤单抗或阿巴西普在特定病例中可能有用。
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