Abstract：
OBJECTIVE: To evaluate the impact of methotrexate and rituximab therapy on highly recurrent idiopathic subglottic stenosis (iSGS) patients with a negative antineutrophil cytoplasmic antibody titer cANCA(-).
METHODS: This was a retrospective cohort study of highly recurrent iSGS patients who recurred within 1 year or less and were treated with methotrexate (MTX), and rituximab (RTX), or a combination of both at different time points (MTX/RTX). Average surgical durations before and after drug treatment were summarized, and the differences were calculated.
RESULTS: A total of 21 female patients with median age of 62 years were included. Fifteen patients were treated with MTX, three were treated with RTX, and five treated with both. Patients treated with immunosuppressants showed a trend toward longer intervals between operations (mean pre-drug interval: 338; mean post-drug interval: 697 days) (p-value = 0.25). Three patients did not recur following drug initiation with median follow-up of 1265 days. All three treatment groups demonstrated a trend toward increased post-drug recurrence intervals (MTX: 444 days, RTX: 374 days, MTX/RTX: 55 days), that was not statistically significant. Patients with prior dilations demonstrated longer post-drug recurrence intervals (mean pre-drug interval: 341 days, mean post-drug interval 978 days) (p-value = 0.17). Four patients in the cohort with the highest recurring disease improved from mean 129 days between operations to 509 days with drug therapy. The most common drug side effect was nausea (16%).
CONCLUSIONS: MTX and RTX may be treatment options for some highly recurrent iSGS patients. Initial results are variable and demonstrate a need for further research on drug candidacy.
METHODS: 3 Laryngoscope, 2024.
METHODS: This was a retrospective cohort study of highly recurrent iSGS patients who recurred within 1 year or less and were treated with methotrexate (MTX), and rituximab (RTX), or a combination of both at different time points (MTX/RTX). Average surgical durations before and after drug treatment were summarized, and the differences were calculated.
RESULTS: A total of 21 female patients with median age of 62 years were included. Fifteen patients were treated with MTX, three were treated with RTX, and five treated with both. Patients treated with immunosuppressants showed a trend toward longer intervals between operations (mean pre-drug interval: 338; mean post-drug interval: 697 days) (p-value = 0.25). Three patients did not recur following drug initiation with median follow-up of 1265 days. All three treatment groups demonstrated a trend toward increased post-drug recurrence intervals (MTX: 444 days, RTX: 374 days, MTX/RTX: 55 days), that was not statistically significant. Patients with prior dilations demonstrated longer post-drug recurrence intervals (mean pre-drug interval: 341 days, mean post-drug interval 978 days) (p-value = 0.17). Four patients in the cohort with the highest recurring disease improved from mean 129 days between operations to 509 days with drug therapy. The most common drug side effect was nausea (16%).
CONCLUSIONS: MTX and RTX may be treatment options for some highly recurrent iSGS patients. Initial results are variable and demonstrate a need for further research on drug candidacy.
METHODS: 3 Laryngoscope, 2024.
摘要：
目的：评估甲氨蝶呤和利妥昔单抗治疗对抗中性粒细胞胞浆抗体滴度cANCA（-）阴性的高度复发性特发性声门下狭窄（iSGS）患者的影响。
方法：这是一项回顾性队列研究，研究对象是在1年内或更短时间内复发并接受甲氨蝶呤（MTX）治疗的iSGS患者，利妥昔单抗（RTX），或两者在不同时间点的组合(MTX/RTX)。总结药物治疗前后的平均手术时间，并计算了差异。
结果：共纳入21例中位年龄为62岁的女性患者。15例患者接受MTX治疗，三个用RTX治疗，五个人都接受了治疗。用免疫抑制剂治疗的患者在手术之间显示出更长间隔的趋势（平均用药前间隔：338；平均用药后间隔：697天）（p值=0.25）。3例患者在药物开始后没有复发，中位随访时间为1265天。所有三个治疗组均显示出药物后复发间隔增加的趋势（MTX：444天，RTX:374天,MTX/RTX：55天），这没有统计学意义。先前扩张的患者表现出更长的药物后复发间隔（平均用药前间隔：341天，平均用药后间隔978天）（p值=0.17）。队列中复发疾病最高的四名患者从手术之间的平均129天改善到药物治疗的509天。最常见的药物副作用是恶心（16％）。
结论：MTX和RTX可能是一些高复发iSGS患者的治疗选择。初步结果是可变的，表明需要进一步研究药物候选人资格。
方法：3喉镜，2024.
方法：这是一项回顾性队列研究，研究对象是在1年内或更短时间内复发并接受甲氨蝶呤（MTX）治疗的iSGS患者，利妥昔单抗（RTX），或两者在不同时间点的组合(MTX/RTX)。总结药物治疗前后的平均手术时间，并计算了差异。
结果：共纳入21例中位年龄为62岁的女性患者。15例患者接受MTX治疗，三个用RTX治疗，五个人都接受了治疗。用免疫抑制剂治疗的患者在手术之间显示出更长间隔的趋势（平均用药前间隔：338；平均用药后间隔：697天）（p值=0.25）。3例患者在药物开始后没有复发，中位随访时间为1265天。所有三个治疗组均显示出药物后复发间隔增加的趋势（MTX：444天，RTX:374天,MTX/RTX：55天），这没有统计学意义。先前扩张的患者表现出更长的药物后复发间隔（平均用药前间隔：341天，平均用药后间隔978天）（p值=0.17）。队列中复发疾病最高的四名患者从手术之间的平均129天改善到药物治疗的509天。最常见的药物副作用是恶心（16％）。
结论：MTX和RTX可能是一些高复发iSGS患者的治疗选择。初步结果是可变的，表明需要进一步研究药物候选人资格。
方法：3喉镜，2024.
