生物/向性合成DMARDs在风湿性关节炎患者中不能阻止骨损失:一个多中心前性观察性研究
Koshiro Sonomoto1,2, Shingo Nakayamada2, Yoshihisa Fujino3
1Department of Clinical Nursing, School of Health Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
Rheumatology (Oxford, England)
|November 7, 2023
概括
对类风湿性关节炎 (RA) 患者的生物/向合成DMARDs (b/tsDMARDs) 治疗可能导致骨质损失. 定期监测骨矿物质密度 (BMD) 对于在RA早期治疗骨质疏松症至关重要.
科学领域:
- 类风湿病学 类风湿病学
- 骨的新陈代谢 骨的新陈代谢
- 药理学 药理学是指药理学的学科.
背景情况:
- 类风湿性关节炎 (RA) 与骨质疏松症的风险增加有关.
- 生物/向合成的疾病修饰性抗风湿药物 (b/tsDMARDs) 有效地控制了RA疾病的活性.
- 在RA患者中,b/tsDMARDs对骨代谢的影响尚未完全理解.
研究的目的:
- 研究b/tsDMARDs对RA患者的骨矿物密度 (BMD) 和骨周转标记 (BTMs) 的影响.
- 为了比较不同类型的b/tsDMARDs对骨代谢的影响.
- 在b/tsDMARDs治疗期间探索BMD和BTM之间的相关性.
主要方法:
- 一项多中心前性观察性研究,涉及1164名RA患者开始他们的第一个b/tsDMARD.
- 骨矿物质密度 (BMD) 和骨循环标记 (BTMs) 在52周的时间内进行了评估.
- 根据患者接受的b/tsDMARD类型和使用抗骨质疏松剂 (anti-OP) 的情况,患者被分类.
主要成果:
- b/tsDMARDs显著改善了RA疾病活性 (CDAI).
- 没有服用抗OP药物的RA患者经历了大腿部和放射性BMD的显著下降.
- 即使控制了疾病活动,骨髓质量也继续下降;没有b/tsDMARD保存骨髓质量. 接受抗OP治疗的患者保持了稳定的BMD.
- 脊髓瘤的变化与骨髓瘤变化没有相关性.
结论:
- 接受b/tsDMARDs治疗而没有抗OP药物的RA患者有骨质疏松症进展的风险.
- 骨周转率标志物可能不会准确地反映b/tsDMARD治疗期间的BMD变化.
- 在接受b/tsDMARD治疗的RA患者中,建议定期对骨质疏松症进行骨质疏松症管理.
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