利图西马布在特殊类型的类型的类风湿性关节炎的疗效和安全性
Satoshi Takanashi1, Yasushi Kondo1, Shuntaro Saito1
1Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
International journal of rheumatic diseases
|September 14, 2023
概括
利图西马布有效治疗类风湿性关节炎并发症,如血管炎和淋巴增殖性疾病. 这种B细胞枯竭疗法改善了疾病活性,并减少了患者的类固醇使用.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
背景情况:
- 类风湿性关节炎 (RA) 可以出现严重的并发症,包括淋巴增殖性疾病和类风湿性血管炎.
- 对于这些激进的RA亚型,标准治疗可能不足.
- 确定有效的治疗选择对于改善患者的治疗结果至关重要.
研究的目的:
- 评估Rituximab在RA患者的疗效和安全性.
- 评估Rituximab对疾病活性评分和葡萄皮质皮质激素需求的影响.
- 为了确定rituximab在治疗RA相关的淋巴增殖性疾病和血管炎中的有用性.
主要方法:
- 对于因淋巴增殖性疾病或血管炎而接受利图西马布治疗的RA患者的回顾性审查.
- 使用28个关节的疾病活动评分-红细胞沉积率 (DAS28-ESR) 和临床疾病活动指数 (CDAI) 评估疾病活动.
- 在随访期间监测安全性,葡萄糖皮质激素剂量和临床结果.
主要成果:
- 在rituximab后12个月的DAS28-ESR和CDAI得分显著改善 (分别p < .001和p = .006).
- 普得尼索隆的平均剂量从7.4毫克/天减少到4.0毫克/天在12个月 (p = .05) 和3.2毫克/天在最后一次访问 (p = .04).
- 一次非B细胞淋巴增殖障碍的复发;在平均52个月的随访期间,血管炎患者的皮肤明显改善.
结论:
- 利图西马布在改善淋巴增殖障碍和血管炎的RA患者的疾病活性方面表现出显著的有效性.
- 利图西马布促进葡萄糖皮质醇节约作用,减少类固醇依赖.
- 通过Rituximab减少B细胞是对这些具有挑战性的RA亚型的有前途的治疗策略.
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