在患有非全身性青少年异常性关节炎的儿童中,生物切换模式
Mia Lindegaard Pedersen1, Amalie Neve-Græsbøll1, Troels Herlin1
1Department of Paediatrics and Adolescent Medicine, Aarhus University Hospital, Palle Juul-Jensens Blvd. 99, Aarhus N, 8200, Denmark.
Pediatric rheumatology online journal
|September 23, 2023
概括
在青少年异常性关节炎 (JIA) 中,超过三分之一的患者因无效而需要切换生物修饰性抗风湿药物 (bDMARDs). 作为一线治疗方法的Etanercept与更高的转换bDMARDs的可能性有关.
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
- 药理学 药理学是指药理学的学科.
背景情况:
- 青春期异常性关节炎 (JIA) 可能无法通过最初的生物修饰性抗风湿药物 (bDMARDs) 实现缓解.
- 切换bDMARD通常是必要的,但最佳的二线选择仍然不清楚.
- 了解非系统性JIA中的bDMARD切换模式对于治疗优化至关重要.
研究的目的:
- 描述bDMARD在患有非全身性JIA的儿童中转换的模式,时间,频率和原因.
- 为了比较bDMARDs转换的患者与没有转换的患者的特征.
- 分析早期和晚期bDMARD切换器之间的差异.
主要方法:
- 对200名患有非全身性JIA的儿童进行了回顾性观察性研究,他们开始了他们的第一个bDMARD.
- 2012年1月至2021年3月期间从电子医疗记录中收集的数据.
- 非切换者与切换者以及早期 (≤6个月) 与晚期 (>6个月) 切换者的比较.
主要成果:
- 37%的患者转换了bDMARDs,失效是主要原因 (57%).
- 作为一线治疗方法的伊坦尼塞普特 (ETN) 与与其他瘤亡因子抑制剂 (TNFis) 相比,更高的切换概率相关.
- 晚期切换者 (77%) 主要因为效率低下而切换.
结论:
- 生物切换在非全身性JIA中很常见,超过三分之一的患者在平均6.3年的随访时间内切换.
- 在这个人群中,低效率是bDMARD转换的主要驱动因素.
- 第一线TNFi选择可能会影响后续的bDMARD切换.
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