根据不同治疗方法在牛皮关节炎中实现的最小疾病活动领域的识别
Silvia Scriffignano1, Fabio Massimo Perrotta2, Paola Conigliaro3
1Academic Rheumatology Unit, Dipartimento Di Medicina E Scienze, Della Salute "Vincenzo Tiberio", Università Degli Studi del Molise, Via Giovanni Paolo II, C/da Tappino, 86100, Campobasso, Italy. silvia.scriff@hotmail.it.
Rheumatology and therapy
|September 16, 2023
概括
牛皮关节炎 (PsA) 中的最小疾病活动 (MDA) 通常在皮肤和关节领域实现,但患者报告的疼痛等结果仍然具有挑战性. 一些先进的疗法,如TNF抑制剂和IL-23抑制剂,显示了实现MDA的更高几率.
科学领域:
- 类风湿病学 类风湿病学
- 皮肤病学 皮肤病学
- 免疫学 免疫学 免疫学
背景情况:
- 牛皮关节炎 (PsA) 是一种慢性炎症性疾病,影响关节和皮肤.
- 疾病活动最小化 (MDA) 是PSA管理中的一个关键治疗目标.
- 了解哪些MDA域在不同的治疗模式中实现,对于优化患者护理至关重要.
研究的目的:
- 描述各种治疗方案下的牛皮关节炎 (PsA) 患者所达到的最小疾病活动 (MDA) 的特定领域.
- 评估不同治疗组之间的关联以及MDA的实现.
- 确定关于患者报告的结果的PsA治疗的潜在未满足需求.
主要方法:
- 两种纵向的PsA队列的横截面分析.
- 患者被分为六个治疗组:NSAIDs/COX2i/类固醇,csDMARDs,TNFi,IL-12/23i或IL-23i,IL-17i和PD4i.
- 使用多变量逻辑回归来评估治疗组与MDA成就之间的关系.
主要成果:
- 在220名PsA患者中,45.8%的人实现了MDA.
- 在所有组中共同实现的MDA领域包括:身体表面积 ≤3,胀关节数 ≤1,和利兹神经炎指数 ≤1.
- 患者整体评估和疼痛VAS是最少经常实现的MDA领域. 在接受TNFi (3组) 和IL-12/23i或IL-23i (4组) 治疗的患者中,观察到MDA实现的几率更高.
结论:
- 患者报告的领域,特别是患者全球评估和疼痛,代表了所有治疗组的PsA管理中的未满足需求.
- 虽然初步,但结果表明基于治疗的MDA域成就的潜在差异,特别是青TNFi和IL-23抑制剂等先进疗法.
- 进一步的大规模,前性研究是有必要的,以证实这些发现,并探索个性化,领域特定的治疗方法,PSA.
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