医学
沙利度胺
不利影响
间质性肺病
肺功能测试
内科学
肺活量
扩散能力
环磷酰胺
胃肠病学
DLCO公司
肺
外科
化疗
多发性骨髓瘤
肺功能
作者
Jie Pan,Fei Dong,Li Ma,Cunyou Zhao,Fang Qin,Jing Wen,Wanling Wei,Ling Lei
标识
DOI:10.1177/23971983231180077
摘要
Objective: To evaluate the clinical efficacy of thalidomide in patients with systemic sclerosis-associated interstitial lung disease. Methods: Ninety-six systemic sclerosis-associated interstitial lung disease patients who received basic glucocorticoid treatment and admitted between 2016 and 2020 were included in this study, including 48 cases in the thalidomide group (combination of thalidomide and cyclophosphamide) and 48 cases in control group (cyclophosphamide monotherapy). Evaluation items included clinical symptoms, modified Rodnan skin score, pulmonary function test, chest high-resolution computed tomography scores, and adverse effects between two groups after 24 weeks of treatment. Results: Remarkable improvements in several aspects were found in the thalidomide group, including modified Rodnan skin score, expiratory dyspnea score, cough visual analog scale score, total ground-glass opacity score, and total interstitial lung disease score. Compared to the control group, improvements in the thalidomide group were found, such as significantly decreased cough visual analog scale score and expectoration; increased number of platelets; improved pulmonary fibrosis ( p = 0.056), and reduced carbon monoxide diffusing capacity ( p = 0.053). There were no statistically significant differences in the expiratory dyspnea score and predicted forced vital capacity between the two groups. Patients who experienced at least one adverse event in the control group and thalidomide group were 33.3% and 64.6% ( p = 0.002); while those with serious adverse events were 8.3% versus 12.5% ( p = 0.504). Venous thrombosis was found in one case in the thalidomide group. Conclusion: Thalidomide combined with cyclophosphamide can improve the symptoms of cough and expectoration in patients with systemic sclerosis-associated interstitial lung disease, and may slightly delay the progression of pulmonary fibrosis, but with the possibility of an increased risk of adverse events.
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