Tratamento da Fasciite Eosinofílica: Estratégias Biológicas Direcionadas e Adjuvantes
Contexto Clínico
A fasciite eosinofílica é uma doença inflamatória rara da fáscia profunda. Este protocolo de primeira linha aborda o espectro completo de opções terapêuticas, incluindo casos graves ou refratários ao tratamento convencional e aqueles que se apresentam com eosinofilia periférica sustentada.
Abordagem Terapêutica Pré-visualização Parcial
O protocolo incorpora terapias biológicas direcionadas — incluindo inibidores da via IL-6, agentes anti-CD20 e inibidores de JAK — juntamente com modalidades adjuvantes. Opções específicas estão disponíveis para pacientes com eosinofilia periférica sustentada. Os critérios completos de seleção, sequenciamento e todos os parâmetros terapêuticos constam no 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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