长期皮下注射丙种球蛋白可有效治疗炎性肌病
作者：CherinP等翻译：邓晓莉
发布者：翟佳羽审校者：李常虹
1
摘要
皮下注射丙种球蛋白主要用于治疗原发或者继发性免疫缺陷病，在自身免疫性疾病中的应用研究很少。本研究目的是描述在真实世界中该治疗在炎性肌病包括多发性肌炎、皮肌炎以及包涵体肌炎中的应用。本研究是回顾性病例分析研究，主要目的是观察该疗法的可行性和依从性，次要目的是安全性和有效性。研究共纳入19例患者，7例多发性肌炎患者，7例包涵体肌炎患者，2例皮肌炎患者以及3例结缔组织病相关性肌炎，平均随访18个月。患者共接受平均64次皮下注射治疗，总和为次治疗。14例患者中10例肌力改善，11例患者中7例肌肉残疾程度改善。2例患者失访。副反应很少见，包括轻微头痛和局部皮肤反应。任何严重不良事件都会上报。结果提示高剂量皮下注射丙种球蛋白治疗炎性肌病是可行的、有益的以及安全的。因此皮下注射丙种球蛋白在下列情况可以作为静脉注射丙种球蛋白的替代治疗：建立静脉通路困难，治疗反应不足，患者想在家治疗。
2
附原文
Subcutaneousimmunoglobulin(SCIg)therapyisindicatedinprimaryandsecondaryimmunodeficiencydiseases.Itsuseinpracticeisbeingextendedtoautoimmunediseases.FewstudiesinvestigatedthefeasibilityandsafetyofSCIgintheserareconditions.TheaimwastodescribetheuseofSCIgininflammatorymyopathiesincludingpolymyositis(PM),dermatomyositis(DM)andinclusionbodymyositis(IBM),inreal-lifesettings.Thiscaseserieswasbaseduponaretrospectivedatacollection.TheprimaryobjectivewastoassessthefeasibilityoftheSCIginjectionsforthetreatmentofautoimmunediseasesandadherencetohighdoses.Secondaryobjectivesincludedsafetyandefficacy.Nineteencaseswereidentified:7patientswerediagnosedwithPM,7withIBM,2withDM,and3withmyositisassociatedwithconnectivetissuedisease.Patientsweretreatedandfollowed-upforameandurationof18.8months(range4.5-42).Theyreceivedamedianof64SCIginfusionsandatotalofinfusions.Outof14patients,10showedanimprovementinmusclestrength,and7outof11showedanimprovementinmuscledisabilityscale.Twopatientswerelosttofollow-up.Fewslightadversereactionswerereportedincludingmainlymildheadachesandlocalskinreactions.Anyseriousadverseeventwasreported.Theseresultssuggestthattheuseofhigh-doseSCIgisfeasible,beneficialandsafeinpatientswithinflammatorymyopathies.SCIgcouldbeanalternativeofIVIginpatientswithdifficultvenousaccessorwithinsufficientresponse,andinpatientspreferringhomecaresetting.
3
引自
CherinP,BeliznaC,CartryO,Lascu-DubosG,deJaegerC,DelainJC,CraveJC,HachullaE.Long-termsubcutaneousimmunoglobulinuseininflammatorymyopathies:Aretrospectivereviewof19cases.AutoimmunRev.Mar;15(3):-6.doi:10./j.autrev..12..EpubDec12.
