J 2022

Léčba nemocnění asociovaného s imunoglobulinem IgG4

ADAM, Zdeněk; Milan DASTYCH; Aleš ČERMÁK; Martina DOUBKOVÁ; Šárka SKORKOVSKÁ et al.

Základní údaje

Originální název

Léčba nemocnění asociovaného s imunoglobulinem IgG4

Název anglicky

Therapy of immunoglonuline IgG4 related disease (IgG4-RD)

Autoři

ADAM, Zdeněk; Milan DASTYCH; Aleš ČERMÁK; Martina DOUBKOVÁ; Šárka SKORKOVSKÁ; Luděk POUR; Zdeněk ŘEHÁK; Renata KOUKALOVÁ; Zuzana ADAMOVÁ; Martin ŠTORK; Marta KREJČÍ a Ivanna BOICHUK

Vydání

Vnitřní lékařství, Praha, Česká lékařská společnost J. E. Purkyně, 2022, 0042-773X

Další údaje

Jazyk

čeština

Typ výsledku

Článek v odborném periodiku

Obor

30203 Respiratory systems

Stát vydavatele

Česká republika

Utajení

není předmětem státního či obchodního tajemství

Odkazy

Označené pro přenos do RIV

Ano

Kód RIV

RIV/00216224:14110/22:00128161

Organizační jednotka

Lékařská fakulta

DOI

EID Scopus

Klíčová slova česky

Abetacept; Dupilimab; Glucocorticoids; IgG4-related disease; Immunosuppressive agents; Rituximab; Sirolimus; Takrolimus

Klíčová slova anglicky

Abetacept; Dupilimab; Glucocorticoids; IgG4-related disease; Immunosuppressive agents; Rituximab; Sirolimus; Takrolimus

Štítky

Příznaky

Recenzováno
Změněno: 8. 2. 2023 14:33, Mgr. Tereza Miškechová

Anotace

ORIG EN

V originále

Immunoglobulin IgG4 related disease (IgG4-RD) is a heterogeneous disorder with multi-organ involvement recognised as a separate entity at the beginning of this century only. Evolving therapy is reviewed in this paper. Glucocorticoids are first choice drug but long administration of glucocorticoids is connected with many adverse effects. In case of combination glucocorticoids and immunosuppressive agents lower doses of glucocorticoids are needed, the response rate is higher and therapy is better tolerated. Rituximab is drug, that is possible use as monotherapy or in combination with glucocorticoids and immunosuppressive drugs. Only one study compared two immunosuporessive drugs, mycophenolate mofetil and cyclophosphamide. The response rated was similar but remissions were longer after glucocorticoids with cyclophosphamide then glucocorticoids with mycofenolat mofetil. No other comparative study of combination of various imunossupressive drugs with glucocorticoids was published. Rituximab has high number (90%) of response rate in monotherapy, but can be used in combination with glucocorticoids and immunosuppressives. Rituximab is now preferred and recommended for maintenance therapy administered in 6-month interval. In case of advanced disease, we prefer therefore combination of rituximab, cyclofosphamide and dexamethasone for initial therapy followed by maintenance with rituximab in 6 months interval. There are two new drugs under investigation abatacept and dupilimab with promising results. Although we have very intensive therapies for good results of therapy early diagnosis before irreversible fibrotic changes in IgG4-RD involved organs is still needed. © 2022, SOLEN s.r.o.. All rights reserved.

Anglicky

Immunoglobulin IgG4 related disease (IgG4-RD) is a heterogeneous disorder with multi-organ involvement recognised as a separate entity at the beginning of this century only. Evolving therapy is reviewed in this paper. Glucocorticoids are first choice drug but long administration of glucocorticoids is connected with many adverse effects. In case of combination glucocorticoids and immunosuppressive agents lower doses of glucocorticoids are needed, the response rate is higher and therapy is better tolerated. Rituximab is drug, that is possible use as monotherapy or in combination with glucocorticoids and immunosuppressive drugs. Only one study compared two immunosuporessive drugs, mycophenolate mofetil and cyclophosphamide. The response rated was similar but remissions were longer after glucocorticoids with cyclophosphamide then glucocorticoids with mycofenolat mofetil. No other comparative study of combination of various imunossupressive drugs with glucocorticoids was published. Rituximab has high number (90%) of response rate in monotherapy, but can be used in combination with glucocorticoids and immunosuppressives. Rituximab is now preferred and recommended for maintenance therapy administered in 6-month interval. In case of advanced disease, we prefer therefore combination of rituximab, cyclofosphamide and dexamethasone for initial therapy followed by maintenance with rituximab in 6 months interval. There are two new drugs under investigation abatacept and dupilimab with promising results. Although we have very intensive therapies for good results of therapy early diagnosis before irreversible fibrotic changes in IgG4-RD involved organs is still needed. © 2022, SOLEN s.r.o.. All rights reserved.