Nội dung được dịch bởi AI, chỉ mang tính chất tham khảo
Cập nhật điều trị bệnh nhược cơ
Tóm tắt
Bài tổng quan này trình bày cập nhật về các chiến lược điều trị hiện tại cho bệnh nhân mắc bệnh nhược cơ (MG) tùy thuộc vào đặc điểm lâm sàng và miễn dịch của họ. Hiện nay, các lựa chọn điều trị có sẵn cho MG bao gồm: (1) ức chế acetylcholinesterase, hữu ích như một phương pháp điều trị triệu chứng; (2) thuốc ức chế miễn dịch, là điều trị chính, được bắt đầu và tăng cường theo các hướng dẫn quốc tế; (3) thuốc điều biến miễn dịch (immunoglobulin tiêm tĩnh mạch và thay huyết tương), chủ yếu được sử dụng trong tình trạng cấp cứu hoặc khủng hoảng MG; và (4) cắt tuyến ức, được thực hiện trên các bệnh nhân có u tuyến ức, cũng như trên các bệnh nhân dưới 65 tuổi có kháng thể chống thụ thể acetylcholine và không có u tuyến ức, theo các khuyến nghị của một thử nghiệm lâm sàng quốc tế gần đây. MG là một bệnh đa dạng, do đó, việc lựa chọn phương pháp điều trị phụ thuộc vào đặc điểm của bệnh nhân, đặc biệt quan trọng là hồ sơ miễn dịch của họ. Ví dụ, những bệnh nhân dương tính với anti-MuSK phản ứng rất tốt với rituximab. Các loại thuốc mới được phê duyệt, như eculizumab và immunoglobulin dưới da, cũng như các thử nghiệm lâm sàng đang diễn ra, được thảo luận. Tiên lượng cho các bệnh nhân MG đã cải thiện đáng kể nhờ vào việc hiểu rõ hơn về sự đa dạng của bệnh và sự xuất hiện của các lựa chọn và cách tiếp cận điều trị mới. Tuy nhiên, tác dụng phụ không phải là hiếm gặp và khoảng 10% bệnh nhân kháng với các phương pháp điều trị thông thường, cho thấy cần phát triển các loại thuốc mới và cụ thể hơn.
Từ khóa
#nhược cơ #điều trị #thuốc ức chế miễn dịch #thuốc điều biến miễn dịch #cắt tuyến ước #kháng thể chống thụ thể acetylcholineTài liệu tham khảo
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