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阿根廷及其他拉丁美洲风湿病学家治疗银屑病关节炎患者时对全身用糖皮质激素的使用情况。

Use of systemic glucocorticoids in patients with psoriatic arthritis by Argentinian and other Latin-American rheumatologists.

机构信息

Rheumatology Service, J. M. Ramos Mejía Hospital, 609, Urquiza Street, 1221, Buenos Aires, Argentina.

出版信息

Rheumatol Int. 2019 Apr;39(4):723-727. doi: 10.1007/s00296-019-04266-z. Epub 2019 Mar 4.

Abstract

To analyse the administration of systemic glucocorticoids (SGC) to patients with Psoriatic arthritis (PsA). Online, anonymous, multiple-choice, closed-ended survey on SGC use in PsA, dose, duration of therapy, and the reason for administration. One hundred and twenty rheumatologists from Argentina (ARG) and 75 from other countries in Latin-America (LAT) completed the survey. Only 6% of the respondents indicated that they did not prescribe SGC, and 65% claimed that they administered them to less than 10% of their patients. Among those physicians who used SGC, 71% prescribed between 5 and 10 mg/day of prednisone, and only 5% over 10 mg/day. Seventy-three percent of the respondents administered SGC for less than 3 months, and 93% associated them with DMARDs, Biological Therapy (BT), or DMARDs plus BT. Clinical indications for SGC were (more than one option was possible): peripheral arthritis (79%), dactylitis (23%), enthesitis (20%), cutaneous involvement (11%), and axial involvement (8%). Thirty-four percent of ARG physicians versus 21% of LAT used SGC in over 10% of their patients (p 0.07) while 76.5% of ARG versus 59% of LAT administered doses higher than 5 mg/day of prednisone (p 0.01). SGC were indicated by most of the rheumatologists surveyed, but only to a reduced number of patients with PsA, at low doses, for short periods of time, associated with DMARDs/BT, and with the aim of treating peripheral joint manifestations. Argentinian physicians tended to prescribe SGC to more patients and at slightly higher doses.

摘要

分析患有银屑病关节炎(PsA)患者的全身糖皮质激素(SGC)治疗管理情况。采用在线、匿名、多项选择、封闭式调查问卷的方式,调查 SGC 在 PsA 中的使用、剂量、治疗持续时间和用药原因。来自阿根廷(ARG)的 120 名风湿病学家和来自拉丁美洲(LAT)其他国家的 75 名风湿病学家完成了该调查。只有 6%的受访者表示他们没有开具 SGC,而 65%的受访者表示他们给不到 10%的患者开具 SGC。在使用 SGC 的医生中,71%的医生开具的泼尼松剂量为 5-10mg/天,只有 5%的医生开具的剂量超过 10mg/天。73%的受访者给患者使用 SGC 的时间不到 3 个月,93%的受访者将 SGC 与 DMARDs、生物疗法(BT)或 DMARDs+BT 联合使用。使用 SGC 的临床指征包括(可选择多个选项):外周关节炎(79%)、指炎(23%)、附着点炎(20%)、皮肤受累(11%)和中轴受累(8%)。34%的 ARG 医生与 21%的 LAT 医生在超过 10%的患者中使用 SGC(p 0.07),而 76.5%的 ARG 医生与 59%的 LAT 医生开具的泼尼松剂量超过 5mg/天(p 0.01)。大多数接受调查的风湿病学家都表明需要使用 SGC,但只有一小部分患有 PsA 的患者接受 SGC 治疗,且剂量低、治疗时间短,与 DMARDs/BT 联合使用,旨在治疗外周关节表现。阿根廷医生倾向于给更多的患者开具 SGC,且剂量稍高。

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