Controversies in the treatment of idiopathic membranous nephropathy.

Controversies in the treatment of idiopathic membranous nephropathy.
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DOI:
10.1038/nrneph.2009.101
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发表时间:
2009-08
影响因子:
41.5
通讯作者:
Austin, Howard A., III
Austin, Howard A., III
中科院分区:
医学1区
文献类型:
--
作者:
Waldman, Meryl;Austin, Howard A., III

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特发性膜性肾病的最佳治疗既有争议又具有挑战性。对于这种疾病,最广泛研究和经常使用的免疫抑制方案包括烷基化剂加皮质类固醇或环孢素。所有这些治疗方案都存在固有的问题:它们并非对所有患者都有效,部分缓解(而非完全缓解)很常见,副作用令人担忧,停止治疗后的复发仍然存在问题。为了克服这些尚未解决的问题,已经测试了替代免疫抑制剂。本文回顾了现有的治疗特发性膜性肾病的现有药物和新药物的证据,重点介绍了最近的临床试验结果。
Optimum treatment of idiopathic membranous nephropathy is both controversial and challenging. The most extensively studied and frequently used immunosuppressive regimens for this disease comprise alkylating agents plus corticosteroids or ciclosporin. All of these treatment options have inherent problems: they are not effective in all patients, partial—rather than complete—remissions are common, adverse effects are worrisome, and relapses after treatment cessation remain problematic. Alternative immunosuppressive agents have been tested in an effort to overcome these unresolved issues. This paper reviews the available evidence regarding both established and new agents for the treatment of patients with idiopathic membranous nephropathy, with an emphasis on the results of the most recent clinical trials.
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