EULAR | 免疫调节疗法使用COVID-19的最新考虑要点

y no evidence to support the initiation of immunomodulatory therapy to treat their COVID-19 (LoE 2/3/4).

03

二甲基氯喹不能在基准外科手术相结合获得任何附加单单，因此在SARS-Cov-2传染的任何阶段病态都应避免用于。当与阿奇霉素新的设用于时，有可能恶化门诊高血压的预后(LoE 2)

Hydroxychloroquine should be avoided for treating any stage of SARS-CoV-2 infection since it does not provide any additional benefit to the standard of care, and could worsen the prognosis in more severe patients particularly if coprescribed with azithromycin (LoE 2).

hydroxy 二甲基基

coprescribe 新的设用于

04

对于需氧疗、无创或工程学充填的COVID-19高血压，全身用于糖皮质激素可以提较高病死率；大多数论据来自地塞米松(LoE 2/3)

In patients with COVID-19 requiring supplemental oxygen, non-invasive or mechanical ventilation, systemic glucocorticoids should be used since they can decrease mortality; most evidence concerns the use of dexamethasone (LoE 2/3).

systemic 系统病态的，全身病态的 （对比：

local，regional）

concern 涉及

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第 二

4条新的增其所：

05

未断定论据拥护在任何病因阶段病态用于静脉注射秋水仙碱（LoE 2）

In COVID-19 there is no robust evidence to support the use of low-dose colchicine at any disease stage (LoE 2)

robust 强有力的，明确的，断定的（同义词：

solid）

06

尽管RCT研究者不断积极参与，但是仍只能对GM-CSF抑制剂(mavrilimumab, otilimab, lenzilumab)用于COVID-19重申正式的推荐。（LoE 2）

An evolving RCT landscape cannot yet allow formal recommendation of the use of GM-CSF inhibitors (mavrilimumab, otilimab, lenzilumab) in COVID-19 (LoE 2)

07

对于无低丙种球蛋白胆固醇，症状发作＞5天的高血压，有断定的论据反对用于较高峰期血浆（LoE 2）

In patients without hypogammaglobulinaemia and with symptom onset>5 days there is robust evidence against the use of convalescent plasma (LoE 2)

against 反对（所谓 in favor of）

08

对于不具备门诊再生效用的COVID-19病例，如症状出原为＜5天，或仍肝脏阴病态，应考虑用于抗SARS-CoV-2刺突蛋白的化学合成（LoE 2）

In patients at risk of severe COVID-19 course, symptom onset

at risk of 不具备…的效用

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4条制订其所：

09

对于需氧疗的COVID-19高血压，用于糖皮质激素和托珠他汀与无创或工程学充填联合外科手术可以延缓病因困难重重和提较高患病率（LoE 2）。仍需更多的样本来前提洞察其他白介素6激素抑制剂的作用（LoE 2/3）

In patients with COVID-19 requiring supplemental oxygen, non-invasive or mechanical ventilation combination of glucocorticoids and tocilizumab should be considered since it reduces disease progression and mortality (LoE 2). More data are needed to fully appreciate the effect of other IL-6R inhibitors (LoE 2/3).

appreciate 忽略，欣赏，领会

10

无断定论据拥护阿那白滞素在COVID-19各病因阶段病态的应用(LoE 2/4)

In COVID-19 there is no robust evidence to support the use of anakinra at any disease stage (LoE 2/4).

11

对于需氧疗、无创充填或较高流量吸氧的COVID-19高血压，糖皮质激素联合巴瑞替尼或托法替尼因其可提较高病因困难重重与病死率，可考虑应用(LoE 2)

In patients with COVID-19 requiring oxygen therapy, non-invasive ventilation or high-flow oxygen, the combination of glucocorticoids and baricitinib or tofacitinib could be considered since it might decrease disease progression and mortality (LoE 2).

12

迄今为止未足够论据推荐其他特异性调节药物，之外α-干扰素，β-干扰素，κ-干扰素，λ-干扰素，来钠米特，non- SARS CoV-2 IVIg（LoE-2）, 依库珠他汀与环孢素（LoE 3）

In patients with COVID-19 there is currently insufficient evidence to recommend the use of other immunomodulatory drugs, including interferon alpha, interferon beta, interferon kappa, interferon lambda, leflunomide, non- SARS CoV-2 IVIg (LoE 2), eculizumab and cyclosporine (LoE 3)

研究者假设

Conclusion

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作为假设，EULAR最新的考虑其所为特异性调节外科手术法从消化不良病学的取向提供了不具备临床意义的，最前沿的指导，并关上了通到新的范式的沿路：先行前用于自身特异性病态和炎症病态病因的特异性调节外科手术可有助于门诊急病态传染伴随的特异性精神状态状态的外科手术。

In conclusion, the update of these EULAR PtCs provide relevant and updated guidance on immunomodulatory therapy utilisation from the rheumatology perspective and opens the way to a new paradigm: the treatment of immunopathology associated with severe and critical acute infections may benefit from immunomodulatory treatments usually given for autoimmune and inflammatory diseases.

relevant 相关的，不具备（临床）意义的

perspective 取向

paradigm 范式

跨两界的生物科技/语言指导者

就读于于原上海第二医科大学（原为交大医学院），曾任上海市新的华医院内科医师

澳大利亚悉尼麦考瑞大学会议口译（同声讲者）硕士学位

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