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肾病治疗药物相关翻译

发布者:鑫达医学翻译 发布时间:2013-05-21 8:50:52 阅读:

原文:
Rituximab for idiopathic membranous nephropathy has shown promise, but so far evidence for its effectiveness is not based on RCT data and the beneficial effects are mostly in reduction of proteinuria rather than preservation of excretory renal function. Furthermore, rituximab is expensive and is associated with important long-term safety concerns such as progressive multifocal leukoencephalopathy. However, progressive multifocal leukoencephalopathy has not been reported in patients with idiopathic membranous nephropathy given rituximab and might be associated with intensity of immunosuppression, since patients who got the disease received rituximab together with other agents. Future RCTs should assess the costeffectiveness, efficacy, and safety of rituximab for patients with idiopathic membranous nephropathy, perhaps compared with prednisolone plus an alkylating agent (either cyclophosphamide or chlorambucil). Future trials should ideally include patient-reported outcomes and an analysis of the balance between treatment costs (including those associated with adverse effects) and costs of renal replacement therapy in untreated patients, so that the cost–benefit of delaying the need for renal replacement therapy and quality-of-life issues can be assessed.

译文:
利妥西单抗用于特发性膜性肾病效果显著,但目前其疗效的证据不是基于RCT数据,而且其疗效主要在于减少蛋白尿不是保护肾排泄功能。此外,利妥西单抗价格昂贵,并涉及重要的长期安全性问题,如进行性多灶性脑白质病。然而,进行性多灶性脑白质病未见报道于利妥西单抗给药的特发性膜性肾病患者中,这可能与免疫抑制的强度有关(患者接受利妥西单抗和其他药物的治疗)。今后的RCT试验应为特发性膜性肾病患者对利妥西单抗的性价比、效果和安全性进行评估,也许要与泼尼松龙加烷化剂(环磷酰胺或苯丁酸氮芥)比较。理论上今后的试验应包括患者报道结果,以及对于未治疗的患者在治疗成本(包括相关不良反应)与肾脏替代疗法成本间的对比分析,从而可以评估延迟所需的肾脏替代疗法带来的成本收益和生活质量问题。


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