Management of HAM/TSP Systematic Review and Consensus-based Recommendations 2019

被引：48

作者：

Araujo, Abelardo ^{[1
]}

Bangham, Charles R. M. ^{[2
]}

Casseb, Jorge ^{[3
]}

Gotuzzo, Eduardo ^{[4
]}

Jacobson, Steve ^{[5
]}

Martin, Fabiola ^{[6
]}

de Oliveira, Augusto Penalva ^{[7
]}

Puccioni-Sohler, Marzia ^{[8
,9
]}

Taylor, Graham P. ^{[10
]}

Yamano, Yoshihisa ^{[11
]}

机构：

[1] Fiocruz MS, Evandro Chagas Natl Inst Infect Dis, Lab Clin Res Neuroinfect, Rio De Janeiro, Brazil

[2] Imperial Coll London, Dept Infect Dis, Sect Immunol Infect, London, England

[3] Univ Sao Paulo, Fac Med, Inst Trop Med Sao Paulo, Sao Paulo, Brazil

[4] Univ Peruana Cayetano Heredia, Inst Med Trop Alexander von Humboldt, Lima, Peru

[5] NIH, Viral Immunol Sect, Bldg 10, Bethesda, MD 20892 USA

[6] Stonewall Med Ctr, Windsor, Australia

[7] Univ Sao Paulo, Inst Infectol, Hosp Emilio Ribas, Sao Paulo, Brazil

[8] Fed Univ State Rio de Janeiro UNIRIO, Rio De Janeiro, RJ, Brazil

[9] Fed Univ Rio de Janeiro UFRJ, Rio De Janeiro, RJ, Brazil

[10] Imperial Coll London, Dept Infect Dis, Sect Virol, London, England

[11] St Marianna Univ, Dept Rare Dis Res, Sch Med, Inst Med Sci, Kawasaki, Kanagawa, Japan

来源：

NEUROLOGY-CLINICAL PRACTICE | 2021年 / 11卷 / 01期

基金：

英国医学研究理事会; 英国惠康基金;

关键词：

MYELOPATHY/TROPICAL SPASTIC PARAPARESIS; MANIFESTATIONS;

D O I：

10.1212/CPJ.0000000000000832

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Purpose of Review To provide an evidence-based approach to the use of therapies that are prescribed to improve the natural history of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP)-a rare disease. Recent Findings All 41 articles on the clinical outcome of disease-modifying therapy for HAM/TSP were included in a systematic review by members of the International Retrovirology Association; we report here the consensus assessment and recommendations. The quality of available evidence is low, based for the most part on observational studies, with only 1 double-masked placebo-controlled randomized trial. Summary There is evidence to support the use of both high-dose pulsed methyl prednisolone for induction and low-dose (5 mg) oral prednisolone as maintenance therapy for progressive disease. There is no evidence to support the use of antiretroviral therapy. There is insufficient evidence to support the use of interferon-alpha as a first-line therapy.

引用

页码：49 / 56

页数：8

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