治疗到目标与固定间隔再治疗策略与风湿性关节炎中rituximab:一个回顾性队列研究
Lisa Schapink1, Nathan den Broeder2, Alfons A den Broeder2,3
1Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands. Lisaschapink@live.nl.
Rheumatology international
|January 29, 2024
概括
对比治疗到目标的再治疗 (TTr) 和固定间隔的再治疗 (FIr) 在风湿性关节炎 (RA) 患者治疗rituximab (RTX) 时,在疾病控制或药物使用方面没有显著差异. 两种RTX再处理策略都为RA管理提供了可比的结果.
科学领域:
- 类风湿病学 类风湿病学
- 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:
- 类风湿性关节炎 (RA) 管理通常涉及生物药物,如rituximab (RTX).
- 优化RTX再治疗策略对于持续的疾病控制和有效的药物利用至关重要.
- 目前的再处理指南包括治疗到目标 (TTr) 和固定间隔再处理 (FIr) 方法.
研究的目的:
- 为了比较TTr与FIr策略在RA患者的RTX再治疗中的有效性.
- 为了评估两种再治疗策略之间的疾病活性,爆发,同时使用药物和RTX剂量的差异.
- 为了确定TTr是否在DAS28-CRP治疗到目标的背景下,在RTX治疗的RA患者中提供优于FIR的结果.
主要方法:
- 在2008年1月至2016年6月期间接受RTX的RA患者的回顾性分析.
- 患者根据TTr,FIr或两种策略的组合被分组.
- 使用线性混合模型分析了28个关节的疾病活性评分,该评分是用C反应蛋白 (DAS28-CRP),爆发,联合药物使用和平均年RTX剂量计算的.
主要成果:
- 在TTr和FIr策略 (0.10 DAS28-CRP点) 之间没有观察到平均DAS28-CRP的显著差异.
- 采用TTr策略并没有导致火焰发作频率增加 (IRR为1.13).
- 在使用常规合成疾病修饰性抗风湿药物或在不同策略之间平均年RTX剂量方面没有发现显著差异.
结论:
- 使用TTr或FIr策略的RTX再治疗在维持RA患者的疾病控制方面表现出可比的有效性.
- 两种策略都没有在DAS28-CRP治疗到目标框架内显著改善疾病控制或减少药物使用.
- 在RA的RTX再治疗中,TTr和FIr之间的选择可以根据患者和医生的偏好以及后勤考虑进行个性化.
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