There is an urgent need to transform care and improve outcomes in immune-mediated diseases where patients continue to face unacceptable outcomes such as permanent organ damage, 不受控制的疾病活动甚至死亡.1-4
Over recent years, Immunology has emerged as one of the fastest-growing fields of clinical research – second only to oncology – in terms of ongoing clinical trials.5
在免疫学领域的影响力越来越大, AstraZeneca intends to help patients with immune-mediated diseases move beyond symptom control to achieve remission, and one day, cure.
跟随免疫驱动疾病领域的科学
尽管免疫学的临床研究正在快速发展, there remains a high unmet need for many people with immune-mediated diseases who do not achieve disease control with existing therapies. 3,6,7 Through decades of research and increased scientific understanding of the underlying drivers of immune-driven diseases at the pathway level, 澳门第一赌城在线娱乐的目标是解开澳门第一赌城在线娱乐所针对疾病的复杂本质, 发现新的治疗方法，推动早期干预.
澳门第一赌城在线娱乐在免疫学领域的雄心壮志——使缓解成为治疗目标
We are continuing to follow the science to further unlock our understanding of complex immune-driven diseases. Our bold ambition in Immunology is to disrupt current treatment paradigms and make remission – not just symptom management – a goal for as many patients as possible.
复杂的自身免疫性疾病，比如狼疮, a disease that can impact any organ and results in often-debilitating flares in disease activity, and immune-mediated inflammatory diseases like eosinophilic granulomatosis with polyangiitis (EGPA), 诊断和治疗仍然具有挑战性, 现在很多病人并没有得到缓解.1,3,8-10 For example, 患有EGPA的人通常需要四年以上的时间才能得到诊断, 狼疮的诊断过程甚至更长(长达6年或更长).1,11 For patients with lupus, 实现疾病控制尤其具有挑战性, 据估计，10-15%的人会因狼疮相关并发症而过早死亡. 1,8
Despite the introduction of updated treatment strategies and novel therapies in systemic lupus erythematosus (SLE) and EGPA, 口服皮质类固醇(OCS)的使用率仍然很高.2,3,9 虽然OCS可以改善症状, 长期使用与生活质量差和严重的副作用有关, with an estimated 50% of patients with SLE developing irreversible organ damage within 5 years of their diagnosis due to their disease and existing treatments.3,9,12-14
缓解是SLE和EGPA指南中的治疗目标. The recently updated international SLE treatment recommendations from the European Alliance of Associations for Rheumatology (EULAR) emphasise the need for prompt initiation of treatment aiming at remission, 哪些与改善临床结果(包括减少器官损伤)相关, fewer flares, reduced hospitalisation, 降低死亡率，提高与健康有关的生活质量. 8,15,16 The revised SLE treatment recommendations advise an OCS-sparing approach (a threshold of 5 mg per day or less) to significantly reduce disease progression and improve quality of life for patients.14
Similarly, treatment of EGPA is focused on preventing relapses and increasing the time spent in remission, 因为OCS使用的复发次数和持续时间与长期器官损害有关.17,18 Global EGPA guidelines recognise both inducing and maintaining remission as a treatment goal and recommend that OCS use is kept to a minimum.19,20
越来越多的证据正在浮出水面, 包括其他慢性病的例子, that could further inform guidelines to drive greater adoption of OCS-sparing strategies and enable physicians to safely and effectively taper their patients from OCS.
Shifting mindsets and implementing the latest treatment recommendations could bring clinical practice closer to other disease areas that have had success, and, ultimately, make a significant impact on the long-term health of people living with chronic immune-driven diseases.
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References
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2. Diane Apostolopoulos, Eric F. 莫兰，它并没有消失:在狼疮中使用糖皮质激素的问题仍然存在， Rheumatology，第56卷，第1期，2017年4月，第i114-i122页。 http://doi.org/10.1093/rheumatology/kew406 [最后访问日期:2023年10月]
3. 张建军，张建军，张建军. Burden of illness and costs associated with eosinophilic granulomatosis with polyangiitis: evidence from a managed care database in the United States. J管理护理规范药房. 2021年9月,27 (9):1249 - 1259. doi: 10.18553/jmcp.2021.21002.
4. 美国嗜酸性疾病合作组织. 嗜酸性肉芽肿伴多血管炎(EGPA). 可在:http://apfed.org/about-ead/eosinophilic-granulomatosis-with-polyangiitis/. [最后访问日期:2023年10月].
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6. Medscape. 系统性红斑狼疮(SLE). 可在:http://emedicine.medscape.http://www.article/332244 -overview[最后访问日期2023年10月]
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14. Bruce IN, et al. Factors associated with damage accrual in patients with systemic lupus erythematosus: results from the systemic lupus international collaborating Clinics (SLICC) inception cohort. Ann Rheum Dis. 2015; 74: 1706-1713
15. Fanouriakis A, et al. EULAR关于系统性红斑狼疮管理的建议:2023年更新. Ann Rheum Dis. 首次在线发布:2023年10月12日. doi: 10.1136/ard-2023-224762.
16. Kandane-Rathnayake R, et al. Lupus low disease activity state and remission and risk of mortality in patients with systemic lupus erythematosus: a prospective, multinational, 纵向队列研究. Lancet Rheumatol. 2022;4(12):e822-e830.
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19. Chung SA, et al. 2021 American College of Rheumatology/Vasculitis Foundation Guideline for the Management of Antineutrophil Cytoplasmic Antibody-Associated Vasculitis. Arthritis Rheumatol. 2021年8月,73 (8):1366 - 1383.
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Veeva ID: Z4-59056
筹备日期:2023年11月