医学
托珠单抗
间质性肺病
阿巴塔克普
美罗华
亚临床感染
特发性肺纤维化
肺
结缔组织
内科学
结缔组织病
疾病
临床试验
病理
重症监护医学
自身免疫性疾病
淋巴瘤
作者
Esther F. Vicente‐Rabaneda,José M. Serra López-Matencio,Julio Ancochea,Ricardo Blanco,Miguel Á. González‐Gay,Santos Castañeda
标识
DOI:10.1080/14740338.2021.1973428
摘要
Interstitial lung disease (ILD) is one of the most important manifestations of connective tissue diseases (CTD) due to its association with high morbidity and mortality.Literature review focused on the evidence on efficacy and safety of biological therapy.Rituximab (RTX) is the most studied drug, though tocilizumab (TCZ) has methodologically more robust evidence, whereas abatacept (ABA) has only anecdotal reports. RTX studies suggest a clinically relevant effect on lung function and fibrosis in refractory to conventional treatment patients, with a good safety profile. Its multi-level efficacy in systemic sclerosis and the potentially more favorable response of anti-synthetase syndrome, especially when administered early in acute-onset or exacerbated ILD stand out over current standard of care, pending the availability of randomized controlled clinical trials. The significant and clinically meaningful benefit found in lung function and fibrosis with TCZ in faSScinate and focuSSced trials represents a change with respect to the usual practice, reinforcing the importance of treatment in early subclinical or clinical SSc-ILD patients with risk factors for ILD progression. This evidence has led to the inclusion of both RTX and TCZ in the expert-based therapeutic algorithms or recommendations for CTD-ILD management.
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