[Evidence-based recommendations for the treatment of rheumatic and immunologic diseases with calcineurin inhibitors: a consensus statement].

Calcineurin inhibitors (CNI), including oral cyclosporin A and tacrolimus, are intensive immunosuppressants that are extensively used in the treatment of rheumatic and immunologic diseases in China. CNI selectively inhibit the activation and proliferation of T lymphocytes and the transcription of cytokines [such as tumor necrosis factor-α, interleukin (IL)-6, and IL-17] through inhibiting the activation of calcineurin in cells and reducing the release of IL-2. To standardize the use of CNI in the field of rheumatic and immunologic diseases, this consensus statement was developed by the National Clinical Research Center for Dermatologic and Immunologic Diseases (Peking Union Medical College Hospital), in conjunction with the Chinese Association of Rheumatology and Immunology Physicians, the Chinese Research Hospital Association, the Rheumatology and Immunology Professional Committee, and the Chinese Association of Rehabilitation Medicine. The 2011 Oxford Centre for Evidence-Based Medicine Levels of Evidence was used to rate the quality of the evidence and the strength of the recommendations, and the RIGHT (Reporting Items for practice Guidelines in HealThcare) checklist was followed to report the consensus. The consensus offers recommendations addressing nine clinical challenges to Chinese clinicians. The primary objective of this consensus is to deliver scientific and detailed guidance on CNI for Chinese clinicians, and to improve the quality of patient-centered medical services.钙调磷酸酶抑制剂（CNI）类药物属强效免疫抑制剂，我国风湿免疫性疾病领域主要应用的该类药物为口服环孢素A和他克莫司，其可通过抑制细胞内钙调磷酸酶活性，减少白细胞介素（IL）-2释放，从而选择性抑制T淋巴细胞活化增殖及肿瘤坏死因子-α、IL-6、IL-17等细胞因子转录。为规范口服CNI类药物在风湿免疫性疾病领域的应用，由国家皮肤与免疫疾病临床医学研究中心（北京协和医院）发起，中国医师协会风湿免疫科医师分会、中国研究型医院学会风湿免疫专业委员会、中国康复医学会风湿免疫康复专业委员会参与制订，采用2011年牛津循证医学中心分级系统和国际实践指南报告标准（RIGHT），对我国临床医生关注的9个临床问题，给出了较为详细的循证推荐意见，旨在为相关医疗卫生人员提供科学、具体的CNI类药物用药参考和指导，提高以患者为中心的医疗服务质量。.