Although the prevention of rheumatic fever and the management of recurrences is well established, the optimal management of active rheumatic carditis is still unclear.
This is an update of a review published in and previously updated in OBJECTIVE To assess the effects of anti-inflammatory agents such as aspirin, corticosteroids, immunoglobulin and pentoxifylline for preventing or reducing further heart valve damage in patients with acute rheumatic fever.
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The presence of cardiac disease one year after treatment was the major outcome criteria selected. Risk of bias was assessed using methodology outlined in the Cochrane handbook. Eight randomised controlled trials involving people were included.
Several steroidal agents corticotrophin, cortisone, hydrocortisone, dexamethasone and prednisone, and intravenous immunoglobulin were compared to aspirin, placebo or no treatment in the various studies. Six of the rheumatic fever were conducted between andone study was done inand the final study was published in Overall there was no significant difference in the risk of cardiac disease at one year between the corticosteroid-treated and aspirin-treated groups six studies, participants, relative risk 0.
Acute Rheumatic Fever and Rheumatic Heart Disease
Similarly, use of prednisone two studies, participants, relative risk 1. Adverse events were not reported in five studies.
Inflammatory disease such as rheumatic fever or lupus Boli inflamatorii, cum ar fi febra reumatică sau lupusul Mitral valve damage can be caused even if the person had rheumatic fever during childhood. Deteriorarea valvei mitrale poate apărea şi dacă persoana a avut febră reumatică în copilărie. The main cause of mitral valve stenosis is rheumatic fever. Principala cauză a stenozei valvei mitrale este febra reumatică.
The three studies reporting on adverse events all reported substantial adverse events. However, all results should be interpreted with caution due to the age of the studies and to substantial risk of bias.
The antiquity of most of the trials restricted adequate statistical analysis of the data and acceptable assessment of clinical outcomes rheumatic fever current standards. Additionally there was substantial risk of bias, so results should be viewed with caution.
Although prevention of rheumatic fever and rheumatic fever of recurrences have been well established, optimal management of active rheumatic carditis remains unclear. This is an update of a review published inand previously updated in and OBJECTIVE To assess the effects, both harmful and beneficial, of anti-inflammatory agents such as aspirin, corticosteroids and other drugs in preventing or reducing further valvular damage in patients with acute rheumatic fever.
New randomised controlled trials in patients with acute rheumatic fever to assess the effects of corticosteroids such as oral prednisone and intravenous methylprednisolone, and other new anti-inflammatory agents are warranted.
Advances rheumatic fever echocardiography will allow for more objective and precise assessments of cardiac outcomes.