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巨细胞动脉炎与创新治疗方法。

Giant cell arteritis and innovative treatments.

机构信息

Department of Medical Sciences and Public Health, University of Cagliari, Cagliari 09100, Italy.

出版信息

Curr Opin Allergy Clin Immunol. 2023 Aug 1;23(4):327-333. doi: 10.1097/ACI.0000000000000923. Epub 2023 Jun 19.

Abstract

PURPOSE OF REVIEW

Giant cell arteritis (GCA) is an idiopathic and persistent condition characterized by granulomatous vasculitis of the medium and large vessels with overlapping phenotypes, including conventional cranial arteritis and extra-cranial GCA, also known as large-vessel GCA. Vascular problems linked with large vessel involvement may partly be caused by delayed diagnosis, emphasizing the necessity of early detection and the fast beginning of appropriate therapy. Glucocorticoids are the cornerstone of treatment for GCA, but using them for an extended period has numerous, often severe, side effects.

RECENT FINDINGS

clinical practice and novel discoveries on the pathogenic pathways suggest that steroid-free biologic treatments may be efficient and safe for GCA patients.

SUMMARY

since now, only Tocilizumab is approved for GCA treatment, but several drugs are currently used, and ongoing trials could give both researchers and patients novel therapeutic strategies for induction, maintenance, and prevention of relapse of GCA. The aims of this work is to synthesize evidence from current studies present in scientific literature about innovative treatment of Giant cell artheritis.

摘要

目的综述

巨细胞动脉炎(GCA)是一种特发性、持续性疾病,其特征为中、大血管的肉芽肿性血管炎,具有重叠表型,包括传统颅动脉炎和颅外 GCA,也称为大血管 GCA。与大血管受累相关的血管问题部分可能是由于诊断延迟所致,这强调了早期发现和快速开始适当治疗的必要性。糖皮质激素是 GCA 治疗的基石,但长期使用会产生许多通常很严重的副作用。

最新发现

临床实践和对发病途径的新发现表明,无类固醇的生物治疗可能对 GCA 患者有效且安全。

总结

迄今为止,只有托珠单抗被批准用于 GCA 治疗,但目前有几种药物正在使用,正在进行的试验可能为研究人员和患者提供新的治疗策略,用于诱导、维持和预防 GCA 的复发。这项工作的目的是综合目前科学文献中关于巨细胞动脉炎创新治疗的研究证据。

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