ANCA関連血管炎:ミコフェノール酸 モフェチルはアザチオプリンより有効性少なく、副作用同等

early release

ANCA関連血管炎、AAV (Wegener granulomatosis or microscopic polyangiitis) において、ミコフェノール酸 モフェチル(Mycophenolate mofetil)は、アザチオプリンより有効性少なく、副事象は同等。

Mycophenolate Mofetil vs Azathioprine for Remission Maintenance in
Antineutrophil Cytoplasmic Antibody-Associated Vasculitis: A Randomized
Controlled Trial
Thomas F. Hiemstra; Michael Walsh; Alfred Mahr; Caroline O. Savage;
Kirsten de Groot; Lorraine Harper; Thomas Hauser; Irmgard Neumann;
Vladimir Tesar; Karl-Martin Wissing; Christian Pagnoux; Wilhelm
Schmitt; David R. W. Jayne; for the European Vasculitis Study Group
JAMA Published online November 8, 2010. doi:10.1001/jama.2010.1658


Therapeutic Interventions for Systemic Vasculitis
Gary S. Hoffman
JAMA Published online November 8, 2010. doi:10.1001/jama.2010.1676

International Network for the Study of Systemic Vasculitides, French Vasculitis Study Group, European Vasculitis Study Group (EUVAS), Italian Vasculitis Study Group, Vasculitis Clinical Research Consortiumにおいて、進展が見られた。

(1) for severe forms of new-onset WG and MPA, substitution of azathioprine for cyclophosphamide after remission induction did not increase relapses and reduced cyclophosphamide toxicity
(2) for milder forms of WG and MPA, methotrexate is as effective as cyclophosphamide for remission induction
(3) among patients with new-onset severe WG or MPA, cyclophosphamide-induced remissions followed by treatment with either azathioprine or methotrexate were highly successful
(4) induction of remission using rituximab is as effective as cyclophosphamide for severe WG and MPA. 


by internalmedicine | 2010-11-09 10:50 | 内科全般  

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