论文部分内容阅读
目的:总结预防视神经脊髓炎谱系疾病(neuromyelitis optica spectrum disorder,NMOSD)发作的药物选择及应用情况,提高对该病预防发作治疗的认识,为临床选择用药提供依据。方法:通过Pub Med检索近年来NMOSD治疗的相关文献,对其免疫抑制剂的选择进行总结分析,并对临床工作中发现的1例NMOSD患儿免疫抑制剂的选择进行分析。结果:预防NMOSD发作,首选利妥昔单抗,其次为霉酚酸酯,再次为硫唑嘌呤。如以上3种免疫抑制剂疗效欠佳,建议换用二线治疗药如甲氨蝶呤、米托蒽醌或环磷酰胺等。基于该患儿的个体差异,建议选择霉酚酸酯治疗,并对其进行药学监护。结论:临床药师对该患儿提出了个体化治疗建议,进一步促进了临床用药的安全性、有效性和合理性。
OBJECTIVE: To summarize the selection and application of drugs to prevent the onset of neuromyelitis optica spectrum disorder (NMOSD), and to improve the understanding of the prevention and treatment of the disease and provide the basis for the clinical choice of drugs. Methods: PubMed was used to search the literature about the treatment of NMOSD in recent years and to summarize the selection of immunosuppressive agents. The selection of immunosuppressive agents in 1 patient with NMOSD was analyzed in clinical work. RESULTS: Prevention of the onset of NMOSD was the first choice of rituximab, followed by mycophenolate mofetil and azathioprine again. If the three immunosuppressive agents ineffective, it is recommended to switch to second-line treatment such as methotrexate, mitoxantrone or cyclophosphamide. Based on the individual differences in this child, it is advisable to choose mycophenolate mofetil and to administer it to pharmacy. Conclusion: Clinical pharmacists put forward individualized treatment recommendations for this child, further promoting the safety, effectiveness and rationality of clinical medication.