■GCA(巨细胞动脉炎)和PMR(风湿性多肌痛)是两种重叠的炎症性风湿性疾病,仅在老年人中出现,分享一些共同的特点。GCA是一种临床综合征,其特征是中大动脉的炎症,同时有颅骨和颅外症状.PMR是一种以颈部僵硬为特征的临床综合征,肩部和骨盆带肌肉。两者都与体质症状有关。
■在这篇评论中,我们评估了GCA和PMR的既定和即将进行的治疗。我们回顾了当前的治疗前景,在这些条件下完成的试验和即将进行的试验,找出新的有前途的疗法。
■早期使用糖皮质激素(GC)仍然是PMR和GCA的即时管理不可或缺的一部分,但了解可能影响治疗毒性的患者合并症至关重要。因此,在PMR的处理中需要GC保护剂。目前,PMR和GCA的治疗方案有限,大量未满足的需求仍然存在。较新的作用机制,因此,正在研究的治疗选择包括CD4T细胞共刺激阻断,IL-17抑制,IL-12/23抑制,GM-CSF抑制,IL-1β抑制,TNF-α拮抗剂和Jak抑制,其中包括将在本次审查中讨论的其他内容。
UNASSIGNED: GCA (giant cell arteritis) and PMR (polymyalgia rheumatica) are two overlapping inflammatory rheumatic conditions that are seen exclusively in older adults, sharing some common features. GCA is a clinical syndrome characterized by inflammation of the medium and large arteries, with both cranial and extracranial symptoms. PMR is a clinical syndrome characterized by stiffness in the neck, shoulder, and pelvic girdle muscles. Both are associated with constitutional symptoms.
UNASSIGNED: In this
review, we assess the established and upcoming treatments for GCA and PMR. We
review the current treatment landscape, completed trials, and upcoming trials in these conditions, to identify new and promising therapies.
UNASSIGNED: Early use of glucocorticoids (GC) remains integral to the immediate management of PMR and GCA but being aware of patient co-morbidities that may influence treatment toxicity is paramount. As such GC sparing agents are required in the treatment of PMR. Currently there are limited treatment options available for PMR and GCA, and significant unmet needs remain. Newer mechanisms of action, and hence therapeutic options being studied include CD4 T cell co-stimulation blockade, IL-17 inhibition, IL-12/23 inhibition, GM-CSF inhibition, IL-1β inhibition, TNF-α antagonist and Jak inhibition, among others, which will be discussed in this
review.