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成人皮肌炎的药物治疗新进展。

Recent Advances in Pharmacological Treatments of Adult Dermatomyositis.

机构信息

Corporal Michael J. Crescenz VAMC, Philadelphia, PA, USA.

Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Suite 1-330A, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA.

出版信息

Curr Rheumatol Rep. 2019 Aug 31;21(10):53. doi: 10.1007/s11926-019-0850-9.

Abstract

PURPOSE OF THE REVIEW

Dermatomyositis (DM) is an uncommon autoimmune disease that primarily affects the skin, muscle, and/or lungs, and remains a therapeutic challenge. We discuss recent studies evaluating efficacy of conventional treatments for clinically amyopathic DM (CADM), DM-associated interstitial lung (ILD) disease, and classic DM (CDM). We highlight several emerging new therapies with a focus on clinical trials, systematic reviews, and case series in the last 5 years.

RECENT FINDINGS

Recent studies report a significant number of patients remain refractory to antimalarials and require second- and third-line agents. Effective treatment for DM-associated ILD can vary based on patient specific antibodies. CDM requires oral glucocorticoids; recent studies have evaluated the benefits of adjunctive therapies including methotrexate and calcineurin inhibitors. New therapies target cell populations or cytokines thought to drive disease pathogenesis. Dermatomyositis is an autoimmune disease that remains challenging to treat. Many patients are refractory to conventional therapies, warranting the development and evaluation of new treatments.

摘要

目的

皮肌炎(DM)是一种罕见的自身免疫性疾病,主要影响皮肤、肌肉和/或肺部,仍然是一个治疗挑战。我们讨论了最近评估传统治疗方法对无肌病性皮肌炎(CADM)、DM 相关间质性肺病(ILD)和经典皮肌炎(CDM)疗效的研究。我们重点介绍了过去 5 年来几项具有临床试验、系统评价和病例系列的新兴新疗法。

最新发现

最近的研究报告称,仍有大量患者对抗疟药有抗药性,需要使用二线和三线药物。针对 DM 相关 ILD 的有效治疗方法可能因患者特定的抗体而异。CDM 需要口服糖皮质激素;最近的研究评估了辅助治疗的益处,包括甲氨蝶呤和钙调神经磷酸酶抑制剂。新疗法针对的是被认为驱动疾病发病机制的细胞群或细胞因子。皮肌炎是一种自身免疫性疾病,仍然难以治疗。许多患者对传统疗法有抗药性,因此需要开发和评估新的治疗方法。

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