关于缩向治疗被用作风湿性关节炎单疗法的知识差距:系统性审查
Charis F Meng1,2, Diviya A Rajesh1, Deanna P Jannat-Khat3,2
1Division of Rheumatology, Hospital for Special Surgery, New York, USA.
Current rheumatology reviews
|August 29, 2023
概括
在类风湿性关节炎 (RA) 中减少向单疗法是具有挑战性的,在停止治疗时缓解率很低. 降低剂量和早期疾病干预可能为RA患者提供更好的结果.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 生物 (b) 疾病修饰性抗风湿药物 (DMARDs) 在多达30%的RA患者中被用作单疗法.
- 干白素 (IL) - 6 抑制剂和雅努斯激酶 (JAK) 抑制剂在RA单一治疗中显示出有效性.
- 在RA中逐渐减少向单一治疗的可行性仍未被探索.
研究的目的:
- 评估控制类风湿性关节炎 (RA) 患者逐渐减缓向单一治疗的可行性.
主要方法:
- 在Medline,Embase和Cochrane图书馆进行了文献搜索,以寻找未来的研究.
- 包括2014年1月至2021年8月间发表的研究.
- 搜索的重点是针对性单疗法在RA患者中逐渐减少后的缓解结果.
主要成果:
- 五项随机性研究评估了TNF抑制剂,托西利祖马布,阿塔切普和巴里西提尼布在RA中的逐渐减少.
- 在停止向单一治疗时,缓解率较低 (14-28%).
- 在早期的RA和剂量减少研究中观察到更高的缓解率 (27-72%).
结论:
- 在文献中,关于在RA中逐渐减少向单一疗法存在一个显著的差距.
- 停止向单一治疗不太可能维持RA的疾病控制.
- 剂量降低和早期RA治疗策略需要进一步研究,以获得成功的逐渐减少.
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