青少年のイディオパシー性関節炎におけるエタネルセプトに対する治療応答に関連する要因
Marieke H Otten1, Femke H M Prince, Wineke Armbrust
1Department of Pediatrics, Sp 1546, Erasmus Medical Center Sophia Children's Hospital, PO Box 2060, 3000 CB Rotterdam, The Netherlands. m.otten@erasmusmc.nl
JAMA
|November 8, 2011
まとめ
エタネルセプトのような生物学的治療法は,若年性イディオパシー関節炎 (JIA) 患者の非活性疾患の現実的な目標を提供します. JIAにおけるエタネルセプトに対する優れた応答を達成することは,初期障害の低さと発症時の年齢の低さに関連しています.
科学分野:
- レウマトロジーの病理学
- 小児リウマト病学について
- 薬理学 薬理学とは
背景:
- 生物学的な治療法は,若年性イディオパシー性関節炎 (JIA) 治療法を変化させ,不活性疾患を達成可能な目標にしました.
- エタナーセプトは,JIAの管理に使用される重要な生物学的剤です.
研究 の 目的:
- JIA患者でエタネルセプトを開始した後の治療応答を評価するために.
- JIAにおけるエタネルセプト治療への反応に関連したベースラインの要因を特定する.
主な方法:
- エタネルセプトを始める生物学的無知なJIA患者の前向きな観察研究 (Arthritis and Biologicals in Children Register) を実施した.
- 開始後15ヶ月で,優秀,中等,または貧弱と分類された応答.
- 分析には262人のJIA患者とフォローアップデータが含まれていました.
主要な成果:
- 15ヶ月で,32%が優れた応答,36%が中間,32%が弱い応答を達成しました.
- 発症時の障害の低さ,DMARDの以前の使用,およびより若い年齢に関連した優れた応答.
- 系統的なJIAと女性の性別に関連した不良応答;不良反応と中止は,不良応答者において高かった.
結論:
- JIA患者の約3分の1は,エタネルセプトに対する優れた,中間的,および貧弱な応答を達成しました.
- 優れた応答の予測要因には,基線下部の障害,以前のDMARD使用,および若い年齢が含まれます.
- システミックなJIAと女性の性別は,エタネルセプトに対する治療応答の低下と関連していました.
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