Esclerosis sistémica
Tratamiento de la esclerosis sistémica
Treatment of systemic sclerosis
Gabriel Medrano Ramíreza, Olga Lidia Vera-Lastrab, Luis J. Jarac,
Autor para correspondencia
luis_jara_quezada@hotmail.com
Correspondencia: Dr. L.J. Jara. Jefe de la División de Investigación. Hospital de Especialidades Dr. Antonio Fraga Mouret. Centro Médico La Raza. Seris/Zaachila, s/n. Colonia La Raza. CP 02990 México DF. México.
Correspondencia: Dr. L.J. Jara. Jefe de la División de Investigación. Hospital de Especialidades Dr. Antonio Fraga Mouret. Centro Médico La Raza. Seris/Zaachila, s/n. Colonia La Raza. CP 02990 México DF. México.
a Departamento de Reumatología. Hospital General de México. SS. México DF. México
b Departamento de Medicina Interna. Universidad Nacional Autónoma de México. México DF. México
c Universidad Nacional Autónoma de México. División de Investigación. Hospital de Especialidades Dr. Antonio Fraga Mouret. Centro Médico La Raza. IMSS. México DF. México
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Jara" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Olga Lidia" "apellidos" => "Vera-Lastra" ] 1 => array:2 [ "nombre" => "Luis J." "apellidos" => "Jara" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X06731060?idApp=UINPBA00004M" "url" => "/1699258X/00000002000000S3/v1_201305061741/S1699258X06731060/v1_201305061741/es/main.assets" ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Esclerosis sistémica</span>" "titulo" => "Tratamiento de la esclerosis sistémica" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "S42" "paginaFinal" => "S45" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Gabriel Medrano Ramírez, Olga Lidia Vera-Lastra, Luis J. 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México" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Departamento de Medicina Interna. Universidad Nacional Autónoma de México. México DF. México" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Universidad Nacional Autónoma de México. División de Investigación. Hospital de Especialidades Dr. Antonio Fraga Mouret. Centro Médico La Raza. IMSS. México DF. México" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Correspondencia: Dr. L.J. Jara. Jefe de la División de Investigación. Hospital de Especialidades Dr. Antonio Fraga Mouret. Centro Médico La Raza. Seris/Zaachila, s/n. Colonia La Raza. CP 02990 México DF. México." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Treatment of systemic sclerosis" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec112023" "palabras" => array:7 [ 0 => "Tratamiento" 1 => "Esclerosis sistémica" 2 => "Antagonistas de los receptores de la angiotensina" 3 => "Antifibróticos" 4 => "Inmunodepresores" 5 => "Bosentán" 6 => "Trasplante de células hematopoyéticas" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec112022" "palabras" => array:7 [ 0 => "Therapy" 1 => "Systemic scherosis" 2 => "Receptors of angiotesin antagonist" 3 => "Antifibrotic agents" 4 => "Immusupressors" 5 => "Bosentan" 6 => "Trasplant of hematopoietic cells" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">El tratamiento de la esclerosis sistémica se basa en 3 tipos de medicamentos modificadores de la enfermedad: fármacos que previenen el daño vascular, agents antifibróticos e inmunomoduladores e inmunodepresores. Los fármacos que previenen el daño vascular son: los antagonistas del calcio, los análogos de las prostaglandinas, los bloqueadores de los receptores de endotelina (bosentán), los inhibidores de la enzima de conversión de la angiotensina, los antagonistas de los receptores de la angiotensina y los inhibidores de la 5’-fosfodiesterasa, y han demostrado eficacia en el fenómeno de Raynaud, la crisis renal y la hipertensión arterial pulmonar. En contraste, los resultados del tratamiento de la fibrosis son poco alentadores y la D-penicilamina continúa siendo motivo de controversia. La terapia inmunodepresora con ciclofosfamida y el trasplante de células hematopoyéticas pueden ser beneficiosos. El conocimiento de la patogenia molecular de la esclerosis sistémica conducirá a nuevas estrategias de tratamiento.</p>" ] "en" => array:1 [ "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Treatment of systemic sclerosis is based upon 3 types of medications modifiers of disease: drugs which prevent vascular damage, antifibrotric agents, and immunomodulators and immunosupressors. Drugs that prevent vascular damage such as: calcium antagonists, prostaglandins analogues, receptors of endothelin blockers (bosentan), inhibitors of angiotensin converting enzyme, receptors of angiotensin antagonists and inhibitors of 5’-phosphodiesterase have been successful in treating the Raynaud’s phenomenon, renal crisis and pulmonary arterial hypertension. In contrast, the results of treatment of fibrosis are discouraging and the D-penicilamine continues being a matter of controversy. The immunosupressor therapy with cyclophosphamide and the transplant of hematopoietic cells, may be beneficial. The knowledge of the pathogenesis of systemic sclerosis to molecular level will lead to new treatment strategies.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:44 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of systemic sclerosis by potentially disease-modifying drugs" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D.E. Furst" 1 => "E.P. Clements" 2 => "J.R. Seibol" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:5 [ "titulo" => "Systemic Sclerosis" "paginaInicial" => "351" "paginaFinal" => "361" "edicion" => "2.ª ed." 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| año/Mes | Html | Total | |
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| 2023 Abril | 49 | 49 | 98 |
| 2023 Marzo | 48 | 87 | 135 |
| 2023 Febrero | 32 | 89 | 121 |
| 2023 Enero | 44 | 53 | 97 |
| 2022 Diciembre | 70 | 67 | 137 |
| 2022 Noviembre | 56 | 95 | 151 |
| 2022 Octubre | 110 | 95 | 205 |
| 2022 Septiembre | 87 | 70 | 157 |
| 2022 Agosto | 56 | 103 | 159 |
| 2022 Julio | 46 | 81 | 127 |
| 2022 Junio | 40 | 142 | 182 |
| 2022 Mayo | 30 | 102 | 132 |
| 2022 Abril | 28 | 166 | 194 |
| 2022 Marzo | 40 | 116 | 156 |
| 2022 Febrero | 37 | 89 | 126 |
| 2022 Enero | 31 | 73 | 104 |
| 2021 Diciembre | 30 | 85 | 115 |
| 2021 Noviembre | 35 | 142 | 177 |
| 2021 Octubre | 52 | 138 | 190 |
| 2021 Septiembre | 35 | 115 | 150 |
| 2021 Agosto | 23 | 103 | 126 |
| 2021 Julio | 61 | 83 | 144 |
| 2021 Junio | 35 | 129 | 164 |
| 2021 Mayo | 30 | 130 | 160 |
| 2021 Abril | 76 | 183 | 259 |
| 2021 Marzo | 62 | 196 | 258 |
| 2021 Febrero | 42 | 54 | 96 |
| 2021 Enero | 39 | 72 | 111 |
| 2020 Diciembre | 37 | 95 | 132 |
| 2020 Noviembre | 29 | 99 | 128 |
| 2020 Octubre | 34 | 104 | 138 |
| 2020 Septiembre | 25 | 65 | 90 |
| 2020 Agosto | 24 | 92 | 116 |
| 2020 Julio | 29 | 127 | 156 |
| 2020 Junio | 23 | 179 | 202 |
| 2020 Mayo | 43 | 137 | 180 |
| 2020 Abril | 37 | 140 | 177 |
| 2020 Marzo | 36 | 156 | 192 |
| 2020 Febrero | 36 | 130 | 166 |
| 2020 Enero | 51 | 126 | 177 |
| 2019 Diciembre | 31 | 133 | 164 |
| 2019 Noviembre | 17 | 195 | 212 |
| 2019 Octubre | 25 | 253 | 278 |
| 2019 Septiembre | 23 | 285 | 308 |
| 2019 Agosto | 30 | 242 | 272 |
| 2019 Julio | 67 | 240 | 307 |
| 2019 Junio | 68 | 227 | 295 |
| 2019 Mayo | 60 | 256 | 316 |
| 2019 Abril | 23 | 311 | 334 |
| 2019 Marzo | 19 | 262 | 281 |
| 2019 Febrero | 14 | 211 | 225 |
| 2019 Enero | 18 | 189 | 207 |
| 2018 Diciembre | 42 | 126 | 168 |
| 2018 Noviembre | 39 | 68 | 107 |
| 2018 Octubre | 26 | 66 | 92 |
| 2018 Septiembre | 24 | 29 | 53 |
| 2018 Agosto | 51 | 42 | 93 |
| 2018 Julio | 6 | 12 | 18 |
| 2018 Mayo | 0 | 9 | 9 |
| 2018 Abril | 13 | 33 | 46 |
| 2018 Marzo | 21 | 38 | 59 |
| 2018 Febrero | 8 | 28 | 36 |
| 2018 Enero | 7 | 21 | 28 |
| 2017 Diciembre | 10 | 25 | 35 |
| 2017 Noviembre | 6 | 17 | 23 |
| 2017 Octubre | 8 | 26 | 34 |
| 2017 Septiembre | 9 | 11 | 20 |
| 2017 Agosto | 10 | 12 | 22 |
| 2017 Julio | 10 | 19 | 29 |
| 2017 Junio | 15 | 12 | 27 |
| 2017 Mayo | 24 | 9 | 33 |
| 2017 Abril | 24 | 11 | 35 |
| 2017 Marzo | 21 | 20 | 41 |
| 2017 Febrero | 9 | 8 | 17 |
| 2017 Enero | 17 | 11 | 28 |
| 2016 Diciembre | 34 | 16 | 50 |
| 2016 Noviembre | 22 | 13 | 35 |
| 2016 Octubre | 36 | 9 | 45 |
| 2016 Septiembre | 31 | 22 | 53 |
| 2016 Agosto | 18 | 6 | 24 |
| 2016 Julio | 16 | 10 | 26 |
| 2016 Junio | 1 | 0 | 1 |
| 2016 Mayo | 1 | 0 | 1 |
| 2016 Abril | 1 | 0 | 1 |
| 2016 Marzo | 1 | 0 | 1 |
| 2016 Enero | 1 | 0 | 1 |
| 2015 Noviembre | 1 | 0 | 1 |
| 2015 Octubre | 2 | 14 | 16 |
| 2015 Septiembre | 6 | 0 | 6 |
| 2015 Agosto | 4 | 5 | 9 |
| 2015 Julio | 42 | 8 | 50 |
| 2015 Junio | 51 | 6 | 57 |
| 2015 Mayo | 87 | 21 | 108 |
| 2015 Abril | 44 | 13 | 57 |
| 2015 Marzo | 56 | 6 | 62 |
| 2015 Febrero | 38 | 8 | 46 |
| 2015 Enero | 45 | 6 | 51 |
| 2014 Diciembre | 45 | 13 | 58 |
| 2014 Noviembre | 50 | 8 | 58 |
| 2014 Octubre | 54 | 9 | 63 |
| 2014 Septiembre | 40 | 8 | 48 |
| 2014 Agosto | 45 | 8 | 53 |
| 2014 Julio | 45 | 15 | 60 |
| 2014 Junio | 46 | 9 | 55 |
| 2014 Mayo | 51 | 12 | 63 |
| 2014 Abril | 53 | 9 | 62 |
| 2014 Marzo | 38 | 12 | 50 |
| 2014 Febrero | 37 | 13 | 50 |
| 2014 Enero | 49 | 6 | 55 |
| 2013 Diciembre | 31 | 9 | 40 |
| 2013 Noviembre | 52 | 21 | 73 |
| 2013 Octubre | 37 | 7 | 44 |
| 2013 Septiembre | 41 | 10 | 51 |
| 2013 Agosto | 33 | 6 | 39 |
| 2013 Julio | 59 | 12 | 71 |
| 2013 Junio | 40 | 18 | 58 |
| 2013 Mayo | 50 | 12 | 62 |
| 2013 Abril | 45 | 11 | 56 |
| 2013 Marzo | 29 | 16 | 45 |
| 2013 Febrero | 25 | 4 | 29 |
| 2013 Enero | 21 | 3 | 24 |
| 2012 Diciembre | 25 | 3 | 28 |
| 2012 Noviembre | 23 | 9 | 32 |
| 2012 Octubre | 7 | 6 | 13 |
| 2012 Septiembre | 6 | 2 | 8 |
| 2011 Mayo | 4 | 0 | 4 |
| 2011 Abril | 13 | 0 | 13 |
| 2011 Marzo | 31 | 0 | 31 |
| 2011 Febrero | 21 | 0 | 21 |
| 2011 Enero | 16 | 0 | 16 |
| 2010 Diciembre | 21 | 0 | 21 |
| 2010 Noviembre | 25 | 0 | 25 |
| 2010 Octubre | 7 | 0 | 7 |
| 2010 Septiembre | 21 | 0 | 21 |
| 2010 Agosto | 36 | 0 | 36 |
| 2010 Julio | 6 | 0 | 6 |
| 2010 Junio | 6 | 0 | 6 |
| 2010 Mayo | 35 | 0 | 35 |
| 2010 Abril | 15 | 0 | 15 |
| 2010 Marzo | 5 | 0 | 5 |
| 2010 Febrero | 1 | 0 | 1 |
| 2010 Enero | 11 | 0 | 11 |
| 2009 Diciembre | 10 | 0 | 10 |
| 2009 Noviembre | 20 | 0 | 20 |
| 2009 Octubre | 12 | 0 | 12 |
| 2009 Septiembre | 17 | 0 | 17 |
| 2009 Agosto | 8 | 0 | 8 |
| 2009 Julio | 11 | 0 | 11 |
| 2009 Junio | 15 | 0 | 15 |
| 2009 Mayo | 20 | 0 | 20 |
| 2009 Abril | 28 | 0 | 28 |
| 2009 Marzo | 14 | 0 | 14 |
| 2009 Febrero | 5 | 0 | 5 |
| 2009 Enero | 2 | 0 | 2 |
| 2008 Diciembre | 8 | 0 | 8 |
| 2008 Noviembre | 11 | 0 | 11 |
| 2008 Octubre | 13 | 0 | 13 |
| 2008 Septiembre | 10 | 0 | 10 |
| 2008 Agosto | 10 | 0 | 10 |
| 2008 Julio | 14 | 0 | 14 |
| 2008 Junio | 11 | 0 | 11 |
| 2008 Mayo | 2 | 0 | 2 |
| 2008 Abril | 13 | 0 | 13 |
| 2008 Marzo | 5 | 0 | 5 |
| 2008 Febrero | 4 | 0 | 4 |
| 2008 Enero | 2 | 0 | 2 |
| 2007 Diciembre | 12 | 0 | 12 |
| 2007 Noviembre | 6 | 0 | 6 |
| 2007 Octubre | 25 | 0 | 25 |
| 2007 Septiembre | 22 | 0 | 22 |
| 2007 Agosto | 32 | 0 | 32 |
| 2007 Julio | 49 | 0 | 49 |
| 2007 Junio | 33 | 0 | 33 |
| 2007 Mayo | 30 | 0 | 30 |
| 2007 Abril | 33 | 0 | 33 |
| 2007 Marzo | 32 | 0 | 32 |
| 2007 Febrero | 19 | 0 | 19 |
| 2007 Enero | 4 | 0 | 4 |
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