在类风湿性关节炎中,基于共享决策的个性化现实生活逐渐缩小方法的治疗模式
Benjamin Birkner1, Jürgen Rech2,3, Edmund Edelmann4
1Hamburg Center for Health Economics (HCHE), Universität Hamburg, Esplanade 36, 20354, Hamburg, Germany. dr.benjamin.birkner@gmail.com.
Zeitschrift fur Rheumatologie
|June 23, 2023
概括
类风湿性关节炎患者表现出多种疾病修饰性抗风湿药物 (DMARD) 逐渐减少的模式,与csDMARDs常见的剂量减少和bDMARDs的间隔间隔. 这些个性化方法突出了临床实践中各种患者管理策略.
科学领域:
- 类风湿病学 类风湿病学
- 临床药理学 临床药理学
- 现实世界 证据研究 实证研究
背景情况:
- 风湿性关节炎 (RA) 管理通常涉及疾病修饰性抗风湿药物 (DMARDs).
- 缩减DMARD是一种在RA患者中实现缓解的策略.
- 了解患者特定的逐渐缩小模式对于优化治疗至关重要.
研究的目的:
- 为在RA患者中提供DMARDs个性化逐渐缩小模式的现实世界证据.
- 在日常临床实践中分析逐渐缩减策略.
- 评估与RA中DMARD逐渐减少相关的结果.
主要方法:
- 一项在德国进行的受控前性队列研究 (2018年7月-2021年3月).
- 分析了200名持续缓解的RA患者的数据,这些患者有资格接受DMARD逐渐减缓.
- 医学结果的描述性分析,逐渐减少的时间和逐渐减少的模式,按药物类别划分.
主要成果:
- 在逐渐减少后,物质组之间没有观察到疾病活性或生活质量的显著差异.
- 第一次逐渐减少的中位时间有所不同:csDMARDs (108天),bDMARDs (189天),组合 (119天).
- 对于csDMARDs (91.8%),剂量减少是常见的,而对于bDMARDs (89.5%),间隔间隔是常见的. 只有10%的人需要增加剂量.
结论:
- DMARD的逐渐缩减模式是高度异质的,无论是在物质组之间还是在物质组内.
- 识别患者个体逐渐缩小的方法可以增强患者和临床医生的RA管理.
- 个性化的逐渐缩减策略有助于有效优化RA治疗.
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