Léčba nemocnění asociovaného s imunoglobulinem IgG4

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. Léčba nemocnění asociovaného s imunoglobulinem IgG4. Vnitřní lékařství. Praha: Česká lékařská společnost J. E. Purkyně, 2022, roč. 68, č. 6, s. "E15"-"E22", 8 s. ISSN 0042-773X. Dostupné z: https://dx.doi.org/10.36290/vnl.2022.086.

Základní údaje

• Originální název: Léčba nemocnění asociovaného s imunoglobulinem IgG4
• Název anglicky: Therapy of immunoglonuline IgG4 related disease (IgG4-RD)
• Autoři: ADAM, Zdeněk (203 Česká republika, garant, domácí), Milan DASTYCH (203 Česká republika, domácí), Aleš ČERMÁK (203 Česká republika, domácí), Martina DOUBKOVÁ (203 Česká republika, domácí), Šárka SKORKOVSKÁ (203 Česká republika, domácí), Luděk POUR (203 Česká republika, domácí), Zdeněk ŘEHÁK (203 Česká republika), Renata KOUKALOVÁ (203 Česká republika), Zuzana ADAMOVÁ (203 Česká republika), Martin ŠTORK (203 Česká republika, domácí), Marta KREJČÍ (203 Česká republika, domácí) a Ivanna BOICHUK (203 Česká republika, domácí).
• Vydání: Vnitřní lékařství, Praha, Česká lékařská společnost J. E. Purkyně, 2022, 0042-773X.

Další údaje

• Originální jazyk: čeština
• Typ výsledku: Článek v odborném periodiku
• Obor: 30203 Respiratory systems
• Stát vydavatele: Česká republika
• Utajení: není předmětem státního či obchodního tajemství
• WWW: URL
• Kód RIV: RIV/00216224:14110/22:00128161
• Organizační jednotka: Lékařská fakulta
• Doi: http://dx.doi.org/10.36290/vnl.2022.086
• 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: rivok
• Příznaky: Recenzováno

Anotace

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.

Anotace 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.