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[关于大血管血管炎治疗的新闻]

[News on the treatment of large vessel vasculitis].

作者信息

Venhoff Nils, Zeisbrich Markus

机构信息

Klinik für Rheumatologie und klinische Immunologie, Universitätsklinikum Freiburg, Hugstetter Straße 55, 79106, Freiburg, Deutschland.

出版信息

Z Rheumatol. 2024 Dec;83(10):812-821. doi: 10.1007/s00393-024-01563-2. Epub 2024 Sep 20.

Abstract

Large vessel vasculitis, such as giant cell arteritis (GCA) and Takayasu arteritis (TAK) are primarily manifested on large and medium-sized arteries. While GCA mainly affects older people after the 6th decade of life onwards, TAK mainly affects young women under the age of 40 years. Glucocorticoids (GC) are still the standard treatment for both diseases. Refractory courses and relapses in particular often lead to long-term treatment with high cumulative doses of GC, which can lead to increased morbidity and mortality. To date, only the interleukin 6 (IL-6) receptor blocker tocilizumab has been approved for the treatment of GCA. The data on methotrexate and other conventional immunosuppressants are incomplete and in some cases contradictory. The early use of steroid-sparing immunosuppressants is recommended for TAK, although the number of randomized placebo-controlled trials is limited and no steroid-sparing treatment has yet been approved for TAK. For both diseases there is still a great need for modern and safe steroid-sparing treatment that effectively treats vasculitis, prevents damage and enables adequate disease monitoring. This article provides an overview of the current study situation and possible future treatment options for GCA and TAK.

摘要

大血管血管炎,如巨细胞动脉炎(GCA)和大动脉炎(TAK),主要表现在大中型动脉。虽然GCA主要影响60岁及以上的老年人,但TAK主要影响40岁以下的年轻女性。糖皮质激素(GC)仍然是这两种疾病的标准治疗方法。难治性病程和复发尤其常常导致高累积剂量GC的长期治疗,这可能导致发病率和死亡率增加。迄今为止,只有白细胞介素6(IL-6)受体阻滞剂托珠单抗已被批准用于治疗GCA。甲氨蝶呤和其他传统免疫抑制剂的数据不完整,在某些情况下相互矛盾。对于TAK,建议早期使用节省类固醇的免疫抑制剂,尽管随机安慰剂对照试验的数量有限,且尚无节省类固醇的治疗方法被批准用于TAK。对于这两种疾病,仍然非常需要现代且安全的节省类固醇治疗方法,这种方法能有效治疗血管炎、预防损伤并实现充分的疾病监测。本文概述了GCA和TAK的当前研究情况以及未来可能的治疗选择。

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