علاج التهاب اللفافة اليوزيني: استراتيجيات مثبطة للمناعة لإدارة موفِّرة للقشرانيات السكرية

References

• Methotrexate (7.5–25 mg/week) is the drug usually recommended as a second-line therapy when corticosteroids alone are not effective for achieving complete remission, when the disease relapses, or due to unacceptable adverse events such as osteoporotic fractures, hyperglycemia or stigmas of hypercortisolism.
• Also, in some clinical situations such as patients who develop some morphea-like lesions, this drug should be considered as a second-line therapy together with the administration of corticosteroids.
• Other immunosuppressive drugs such as azathioprine (1–2 mg/kg/day), cyclosporin (100–150 mg/day), biologic agents (rituximab, tumor necrosis factor blockers, interleukin-6 receptor inhibitors) and hydroxychloroquine are also included as a second-line therapy in EF.
• Mycophenolate mofetil (1 g/12 h) plus intravenous immunoglobulins (0.4 gr/kg/d × 5 days, once a month × 6 months) may be useful in severe situations such as perimyositis or restrictive respiratory failure due to trunk skin induration.
• Thus, mycophenolate mofetil is a good option as a second-line therapy for patients with EF.