Tratamiento de la Fasciitis Eosinofílica: Estrategias Biológicas Dirigidas y Adyuvantes
Contexto Clínico
La fasciitis eosinofílica es un trastorno inflamatorio poco frecuente de la fascia profunda. Este protocolo de primera línea aborda el espectro completo de opciones terapéuticas, incluidos los casos graves o refractarios al tratamiento convencional, y aquellos que se presentan con eosinofilia periférica sostenida.
Enfoque Terapéutico Vista Parcial
El protocolo incorpora terapias biológicas dirigidas —incluidos inhibidores de la vía IL-6, agentes anti-CD20 e inhibidores JAK— junto con modalidades adyuvantes. Se dispone de opciones específicas para pacientes con eosinofilia periférica sostenida. Los criterios de selección completos, la secuenciación y todos los parámetros terapéuticos figuran en el protocolo completo.
References
DOI: 10.1007/s40674-024-00222-6
- IL-6 blocking by a humanized monoclonal antibody, tocilizumab, recently has gained interest in the treatment of EF when other more conventional agents such as methotrexate or mycophenolate mofetil are not working as a second-line glucocorticoid-sparing agents.
- A total of 8 cases of patients with refractory EF have been reported who successfully respond to rituximab. Thus, this biological therapy could be a therapeutical option in severe and refractory cases of EF.
- Patients with EF refractory to conventional therapy have been reported with a successful response to any one of the JAK inhibitors, baricitinib or tofacitinib.
- It is well-known that IL-5 plays a role in the maturation, recruitment, and proliferation of eosinophils, thus it seems logical that monoclonal antibodies directed to the cytokine (mepolizumab or reslizumab, human monoclonal antibodies against IL-5) or to their receptor (benralizumab) may be useful in some cases that do not respond to the usual therapy with prednisone or immunosuppressive drugs.
- At least in those patients with sustained peripheral eosinophilia.
- UVA-1 phototherapy or irradiation (90 J/cm, for 40 consecutive sessions, 3–4 times a week) is an alternative therapy for difficult cases of EF.
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