类风湿性关节炎患者在现实生活环境中2年多的葡萄糖皮质激素轨迹
Alycia Delteil1, Celine Lambert2, Bruno Pereira2
1Rheumatology, University Hospital Centre Clermont-Ferrand, Clermont-Ferrand, France.
RMD open
|October 25, 2023
概括
几乎一半的类风湿性关节炎患者使用葡萄糖皮质类药物 (GCs). 大多数用户长期保持低剂量GC,这表明停药的挑战和需要个性化GC逐渐减少策略.
科学领域:
- 类风湿病学 类风湿病学
- 药理学 药理学是指药理学的学科.
- 临床研究 临床研究
背景情况:
- 风湿性关节炎 (RA) 管理通常涉及葡萄糖皮质类药物 (GCs).
- 了解RA中长期GC使用模式对于优化患者结果至关重要.
- 在已建立的RA中,关于GC轨迹的现实数据有限.
研究的目的:
- 分析葡萄糖皮质体 (GC) 的使用,并确定不同使用轨迹在现实生活中的类风湿性关节炎 (RA) 患者队列.
- 为了比较两年来不同GC使用模式之间的特征和结果.
主要方法:
- 在纵向RCVRIC队列中对开始或改变生物疾病修饰性抗风湿药物的患者进行分析.
- 基于组的轨迹建模以评估GC剂量在2年的随访期间.
- 在已识别的轨迹中比较患者特征和临床结果.
主要成果:
- 44%的RA患者 (n=184) 在基线使用了GC;这些用户年龄较大,疾病活性和并发症较高.
- 两个GC轨迹出现了:25%的人在一年内停止了GC,而75%的人在2年内保持了低剂量的GC.
- 长期的GC维护与更高的HAQ得分,更长的GC持续时间,更少使用甲状腺素,以及6个月和1年的EULAR反应较差,以及糖尿病,骨折和BMI的发病率增加.
结论:
- 葡萄皮质皮质类药物在现实世界的RA管理中普遍存在.
- 大多数接受GC治疗的RA患者倾向于长期维持低剂量使用,这突出了停止GC治疗的困难.
- 需要个性化的GC逐渐缩减策略,考虑到疗效安全平衡和患者特定因素.
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