摘要
干燥综合征(SjS)是最常见的风湿免疫病之一,临床实践中普遍存在超说明书用药现象。为此,中国初级卫生保健基金会风湿免疫学专业委员会组织专家通过循证查证及系统评价超药品说明书用药治疗SjS的依据,除参考已公开发布的指南、共识、诊疗规范等外,还对已上市的免疫抑制药物治疗SjS的随机对照试验进行再评估,采用2022年提出的评价SjS治疗应答新工具(STAR)的单项分解条目作为结局,设计相应的临床问题,依据人群、干预、对照和结局(PICO)原则完成证据检索、荟萃分析及推荐意见分级的评估、制订及评价(GRADE)分级与推荐,最终形成针对12个临床问题的21条推荐意见,包括2条强推荐、14条弱推荐和5条基于共识的推荐,旨在为临床医师提供合理用药依据并为药学部门管理提供参考。
Sjögren′s syndrome(SjS)is one of the most prevalent rheumatic diseases.Off-label drug use is very common in the clinical practice of the treatment of SjS.In order to establish evidence-based justifications and systematically evaluate the off-label drug use in SjS treatment,the Committee of Chinese Primary Health Care Foundation for Rheumatologists and Immunologists referred to published guidelines,consensus statements,and case series,and reevaluated the outcomes of the randomized controlled trials about the marketed immunosuppressive drugs treating SjS.The single-item breakdown of the Sjögren′s tool for assessing response(STAR)which was proposed in 2022 was employed as the outcome.The committee established the corresponding clinical questions based on the population,intervention,comparison,and outcome(PICO)principle,and then carried out evidence retrieval,and synthesized meta-analysis using the grading of recommendations,assessment,development,and evaluation(GRADE)methodology.Finally,21 recommendations addressing twelve clinical questions were formed which included two strong recommendations,fourteen weak recommendations,and five consensus-based recommendations.The overarching objective of the guideline is to provide clinicians with a rational basis for medication selection and to offer guidance to pharmacy departments for management purposes.
作者
中国初级卫生保健基金会风湿免疫学专业委员会
戴冽
莫颖倩
何菁
厉小梅
Committee for Rheumatologists and Immunologists of Chinese Primary Health Care Foundation;Dai Lie(不详;Department of Rheumatology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2023年第43期3445-3461,共17页
National Medical Journal of China
基金
广东省基础与应用基础研究基金自然科学基金(2023A1515011922)
广州市科技计划(登峰医院)基础研究(2023A03J0725、2023A03J0710)
关键词
干燥综合征
超说明书用药
实践
指南
Sjögren′s syndrome
Off-label drug use
Clinical practice
Guidelines
