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Rheumatology:吗替麦考酚酯在青少年特发性炎性肌病中的应用经验

2022-08-10 紫菀款冬 MedSci原创

评价吗替麦考酚酯(MMF)治疗青少年特发性炎性肌病(JIIM)的疗效和安全性。

目的:评价吗替麦考酚酯(MMF)治疗青少年特发性炎性肌病(JIIM)疗效和安全性

方法:在英国青少年皮肌炎研究组(JDRG)或意大利热那亚Giannina Gaslini研究所的确诊为JIIM并接受MMF治疗的患者被纳入研究。

MMF开始时、治疗开始后第3、6、12个月和最后一次随访时回顾性收集以下信息:临床表现、实验室数据、医生对疾病活动的主观评估、肌力/耐力的标准化结果测量、皮肤疾病活动、身体功能、整体疾病活动、累积损伤和持续治疗。

结果:29例患者中,23例为青少年皮肌炎,6例为重叠性肌炎。在施用MMF期间,肌肉力量、皮肤病活动和整体疾病活动的测量值有所改善,手动肌肉测试-8的正常得分频率从50.0%增加到83.3%,儿童肌炎活动得分从53.5%增加到88.9%,疾病活动得分(DAS)的肌肉成分从55.2%增加到84.2%,DAS的皮肤成分从31.0%提高到42.1%,皮肤病活动的视觉模拟评分(VAS)从25.0%到47.4%,整体疾病活动的VAS从7.1%到42.1%。

无活动性疾病患者的数量从基线时的10.3%增加到最后一次随访时的68.5%。皮质类固醇剂量显著减少0.3-0.1 mg/kg/day。未报告相关副作用。

结论:该研究表明,MMF是治疗JIIM的一种有价值的治疗选择

文献来源:

Varnier GC, Consolaro A, Cheng IL, et al. Experience with the use of mycophenolate mofetil in juvenile idiopathic inflammatory myopathies [published online ahead of print, 2022 Aug 5]. Rheumatology (Oxford). 2022;keac404. doi:10.1093/rheumatology/keac404

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