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Immunosuppressive and cytotoxic therapy for pulmonary sarcoidosis.

Identifieur interne : 000036 ( Ncbi/Merge ); précédent : 000035; suivant : 000037

Immunosuppressive and cytotoxic therapy for pulmonary sarcoidosis.

Auteurs : S. Paramothayan ; T. Lasserson ; E H Walters

Source :

RBID : pubmed:12917971

Descripteurs français

English descriptors

Abstract

Immunosuppressive and cytotoxic agents have been used as both an alternative to oral corticosteroids, and as a means of maintaining a low dose of steroids in the treatment of pulmonary sarcoidosis.

DOI: 10.1002/14651858.CD003536
PubMed: 12917971

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pubmed:12917971

Le document en format XML

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<name sortKey="Paramothayan, S" sort="Paramothayan, S" uniqKey="Paramothayan S" first="S" last="Paramothayan">S. Paramothayan</name>
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<nlm:affiliation>Respiratory Medicine, Kingston Hospital NHS Trust, Galsworthy Rd, Kingston Upon Thames, Surrey, UK, KT2 7QB.</nlm:affiliation>
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<name sortKey="Lasserson, T" sort="Lasserson, T" uniqKey="Lasserson T" first="T" last="Lasserson">T. Lasserson</name>
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<name sortKey="Walters, E H" sort="Walters, E H" uniqKey="Walters E" first="E H" last="Walters">E H Walters</name>
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<term>Antineoplastic Agents (adverse effects)</term>
<term>Antineoplastic Agents (therapeutic use)</term>
<term>Chloroquine (therapeutic use)</term>
<term>Cyclosporine (therapeutic use)</term>
<term>Humans</term>
<term>Immunosuppressive Agents (adverse effects)</term>
<term>Immunosuppressive Agents (therapeutic use)</term>
<term>Methotrexate (therapeutic use)</term>
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<term>Antinéoplasiques (effets indésirables)</term>
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<term>Méthotrexate (usage thérapeutique)</term>
<term>Sarcoïdose pulmonaire (traitement médicamenteux)</term>
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<term>Immunosuppressive Agents</term>
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<term>Antineoplastic Agents</term>
<term>Chloroquine</term>
<term>Cyclosporine</term>
<term>Immunosuppressive Agents</term>
<term>Methotrexate</term>
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<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en">
<term>Sarcoidosis, Pulmonary</term>
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<term>Antinéoplasiques</term>
<term>Immunosuppresseurs</term>
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<term>Sarcoïdose pulmonaire</term>
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<term>Antinéoplasiques</term>
<term>Chloroquine</term>
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<term>Méthotrexate</term>
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<term>Randomized Controlled Trials as Topic</term>
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<div type="abstract" xml:lang="en">Immunosuppressive and cytotoxic agents have been used as both an alternative to oral corticosteroids, and as a means of maintaining a low dose of steroids in the treatment of pulmonary sarcoidosis.</div>
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<AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Immunosuppressive and cytotoxic agents have been used as both an alternative to oral corticosteroids, and as a means of maintaining a low dose of steroids in the treatment of pulmonary sarcoidosis.</AbstractText>
<AbstractText Label="OBJECTIVES" NlmCategory="OBJECTIVE">To determine the efficacy of immunosuppressive and cytotoxic agents in the treatment of pulmonary sarcoidosis.</AbstractText>
<AbstractText Label="SEARCH STRATEGY" NlmCategory="METHODS">The Cochrane Airways Group trials register was searched for possible randomised trials. Bibliographies were searched for other potentially relevant trials. Searches were current as of February 2001.</AbstractText>
<AbstractText Label="SELECTION CRITERIA" NlmCategory="METHODS">Randomised controlled trials comparing an immunosuppressive or cytotoxic therapy with a control in patients with pulmonary sarcoidosis were included in the review.</AbstractText>
<AbstractText Label="DATA COLLECTION AND ANALYSIS" NlmCategory="METHODS">Two reviewers independently extracted data for entry in to the Review Manager statistical package (MetaView 4.1). Pharmaceutical companies and study investigators were contacted for unpublished trials.</AbstractText>
<AbstractText Label="MAIN RESULTS" NlmCategory="RESULTS">Four studies were included in the review. Trials comparing methotrexate, chloroquine and cyclosporin A were identified. No data could be combined for a meta-analysis. Data on lung function, chest x-ray scores and dyspnoea were largely inconclusive. Adverse effects were associated with methotrexate, cyclosporin A and chloroquine. In one small study, methotrexate was associated with a steroid sparing effect after 12 months of therapy, but no difference was observed at 6 months.</AbstractText>
<AbstractText Label="REVIEWER'S CONCLUSIONS" NlmCategory="CONCLUSIONS">The current body of evidence supporting the use of immunosuppressive agents and cytotoxic therapies is limited. Side-effects associated with some of the therapies were severe.</AbstractText>
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