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发布于:2019-1-8 08:01:14  访问:32 次 回复:0 篇
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Y. Arnal et al74 studied 59 sufferers with SLE with
Of these 50, 40 had an acute response to Hygromycin B site glucocorticoid therapy that resulted within a rise in the platelet count. Danazol was added in 12 in the 18 patients since they had failed a further remedy.74 A sustained response was noted in nine with mean follow-up of 28 months.74 A different somewhat significant study of danazol followed 16 consecutive patients with SLE with thrombocytopenia from a single centre over a 5-year period. All had an excellent or superb response inside two months to danazol, which was began at 200 mg/day and enhanced by 200 mg each and every four weeks until PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/21795619 a response was noted.Y. Arnal et al74 studied 59 patients with SLE with thrombocytopenia, who
Y. Arnal et al74 studied 59 patients with SLE with thrombocytopenia, who have been treated at 5 French centres. Of these 59 individuals, 57 received oral glucocorticoid as initially and sole therapy; and of PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/25017212 these, 50 were evaluated long-term (the remaining 9 received some other therapy along with glucocorticoid and had been excluded from the evaluation). Of these 50, 40 had an acute response to glucocorticoid therapy that resulted inside a rise in the platelet count. Nevertheless, only 11 had a sustained response in mean follow-up of 78 months. Also, eight of these 11 patients had typical platelet counts and had been free of charge from therapy following an typical of 13 months of glucocorticoid therapy. Therefore, the sustained remission price was low (22 ), and eventually, 78 on the patients have been classified as longFayyaz A, Igoe A, Kurien BT, et al. Lupus Science Medicine 2015;two:e000078. doi:10.1136/lupus-2014-Lupus Science Medicine term failures. Within this very same study, 10 individuals were treated with high-dose intravenous methylprednisolone with an initial response rate of 60 ; on the other hand, no patient had a sustained response,74 while one patient using a sustained response has been reported.75 Thus, oral or highdose intravenous glucocorticoids generate a response in the majority of individuals initially, but sustained response to this therapy is unlikely. Nonetheless, this therapy may well be incredibly helpful in the patient with serious thrombocytopenia. Danazol, a weak androgenic steroid, has also been utilised in the remedy of thrombocytopenia attributable to SLE, although its comprehensive mechanism of action is still unknown (table two).74 76?9 Many case reports demonstrate results in sufferers that have failed other treatment options.76 In a randomised controlled blinded trial of danazol in seven sufferers with mild SLE, the main impact noted was improvement of thrombocytopenia. With 1 month of danazol therapy, preceded and followed by 1 month of placebo, the 3 patients with thrombocytopenia all had improvement in the platelet count.77 In an additional study, West and colleagues applied danazol (800 mg/day initially for eight weeks) in six sufferers with SLE with extreme thrombocytopenia, all of whom had failed glucocorticoid remedy. Four in the six had failed splenectomy.79 At 8 weeks, all had normal platelet counts and had been on reduce doses of glucocorticoid. 5 have been followed for 1 year, and all maintained a typical platelet count on reduced doses of danazol, ranging from 200 to 600 mg/day.
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