利妥昔单抗治疗特发性炎性肌病的系统评价
| 作者: |
1刘玉叶,
2陈秀敏,
2黄闰月,
2黄清春
1 广州中医药大学第二临床医学院，广州 510504 2 广东省中医院风湿科，广州 510006 |
| 通讯: |
刘玉叶
Email: 693976420@qq.com 黄清春 Email: qch1963@163.com |
| DOI: | 10.3978/j.issn.2095-6959.2015.12.017 |
| 基金: | 国家中医药管理局中医药标准化项目——皮肌炎, SATCM-2015-BZ(186) |
摘要
目的：评价rituximab治疗炎性肌病的有效性和安全性，探讨其再次使用的指征和时间。方法：检索至2015年8月PubMed、中国知网(National Knowledge Infrastructure，CNKI)、万方、维普数据库中使用rituximab治疗炎性肌病的文献，根据纳入和排除标准，筛选合适文献，进行分析整理。结果：筛选出15篇文献，包括随机对照试验(RCT)1篇(n=200)、前瞻性研究5篇(n=57)、回顾性研究3篇(n=30)、个案总结6篇(n=37)。综合分析，rituximab治疗难治性有确切疗效，常见毒副作用为感染和输液反应。再次使用rituximab以肌酶、肌力的改变为参考，时间绝大多数在1年内。结论：rituximab是治疗难治性肌炎的重要药物，治疗的有效性确定，毒副作用常见但耐受性好。
关键词：
利妥昔单抗
难治性
炎性肌病
皮肌炎
多发性肌炎
系统评价
Rituximab in the treatment of idiopathic inflammatory myopathies: a qualitative systematic review
CorrespondingAuthor: LIU Yuye Email: 693976420@qq.com
DOI: 10.3978/j.issn.2095-6959.2015.12.017
Abstract
Objective: To summarize and evaluate published information on the effectiveness and adverse effects of rituximab (RTX) in treating patients with idiopathic inflammatory myopathies (IIM). To explore the indications and time of using RTX again. Methods: A search was conducted in PubMed, CNKI, Wanfang and VIP from its establishment to August 2015. Then select the eligible literature according to the selection and exclusion criteria, and analysis. Results: Fifteen eligible reports were identified in this study, including 1 randomized controlled trail, 5 prospective trials, 3 respective studies, and 6 case series. RTX had confirmatory effectiveness in the treatment of refractory myositis. The most common side effect is infection and transfusion reaction. Almose within 1 year, people needed to treat with RTX again depending on the exacerbate of creatase and muscle strength. Conclusion: RTX exhibited a definite effect for the treatment of refractory myositis. Side effects were common but well tolerate.