在青少年白内障性关节炎的全身治疗被撤回时,应该期待什么?
Juan Carlos Nieto-González1, Daniel Clemente Garulo2, Alina Boteanu3
1J.C. Nieto-González, MD, PhD, L. Trives-Folguera, MD, I. Monteagudo-Saéz, MD, PhD, Department of Rheumatology, Hospital General Universitario Gregorio Marañón; juancarlos.nietog@gmail.com.
The Journal of rheumatology
|August 1, 2023
概括
青少年无形性关节炎治疗的停止往往会导致爆发. 停止使用生物药物时,爆发更常见,而不是甲状腺素,特别是在未使用生物药物的患者中.
科学领域:
- 儿科风湿病学 儿科风湿病学
- 免疫学 免疫学 免疫学
- 临床药理学 临床药理学
背景情况:
- 青春期异常性关节炎 (JIA) 治疗的目的是缓解和降低药物毒性.
- 系统性停止治疗是一种尽量减少副作用的策略.
- 在停止治疗后预测缓解生存率对于患者管理至关重要.
研究的目的:
- 分析JIA患者在全身性治疗停止后的缓解生存率.
- 确定影响缓解持续时间和爆发发生的因素.
- 根据不同的全身治疗方案和JIA亚型,比较缓解生存期.
主要方法:
- 一个多中心的,观察性的,纵向研究设计.
- 卡普兰-梅尔曲线用于分析缓解生存率.
- 用多变量分析来检查火焰的风险因素.
- 包括404名JIA患者,分析了185名退出治疗的患者.
主要成果:
- 在停止治疗后,59%的患者出现了爆发,爆发的中位时间为2.3年.
- 取消生物修饰性抗风湿药物 (bDMARDs) 导致57%的病例爆发 (爆发的中位时间:1.1年).
- 在29%的患者中,在联合治疗后停止单独使用甲状腺素 (MTX) 导致爆发 (爆发的中位时间:6.3年).
结论:
- 在JIA中,在全身性治疗停止后,爆发是常见的.
- 与停止MTX相比,停止bDMARD与更高的爆发率和更短的缓解持续时间有关.
- 尿道炎和关节注射可能是发作风险因素;较长的缓解期 (>1年) 可能会减少发作频率.
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