在6个月和12个月的青少年异形性关节炎缓解期中停止使用甲甲酸:一项随机临床试验
Dirk Foell1, Nico Wulffraat, Lucy R Wedderburn
1Department of Pediatrics, University of Muenster, Albert-Schweitzer-Strasse 33, D-48149 Muenster, Germany. dfoell@uni-muenster.de
JAMA
|April 8, 2010
概括
延长青少年异常性关节炎 (JIA) 的甲状腺素治疗并没有降低复发率. 然而,肌肉骨髓相关蛋白8和14 (MRP8/14) 水平的升高表明,在停止药物治疗后,爆发的风险更高.
科学领域:
- 类风湿病学 类风湿病学
- 儿科免疫学 儿科免疫学
- 临床试验研究 临床试验研究
背景情况:
- 新型疗法改善了青少年异常性关节炎 (JIA) 的缓解率.
- 紧缩疗法和识别亚临床炎症是管理JIA的关键挑战.
- 需要生物标志物来预测药物停用后复发风险.
研究的目的:
- 为了确定延长JIA患者的甲状腺素治疗是否可以减少停药后的复发率.
- 调查骨髓相关蛋白8和14 (MRP8/14) 是否可以预测JIA患者的发作.
主要方法:
- 一项前性随机临床试验,涉及61个中心的364名JIA患者.
- 患者在实现缓解后接受甲状腺素治疗6个月或12个月.
- 骨髓相关蛋白8和14 (MRP8/14) 水平在治疗停止时被测量.
主要成果:
- 在6个月和12个月的甲状腺素组之间,复发率没有显著差异 (56.7%对比55.6%).
- 较高的MRP8/14水平与随后的爆发有显著的关联 (P = .003).
- 低MRP8/14水平预测了3个月内爆发的低风险 (AUC = 0.76).
结论:
- 与6个月相比,12个月的甲状腺素戒断策略并没有降低JIA患者的复发率.
- 较高的MRP8/14度与在停止服用甲状腺素后复发的风险增加有关.
- MRP8/14作为一个潜在的生物标志物用于预测JIA中的火焰.
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