在中度和严重类风湿性关节炎中开始使用生物药物:加拿大注册局的现实经验
Nancy Guo1, Xiuying Li2, Mohammad Movahedi3
1Kingston Health Sciences Centre, Kingston, Ontario, Canada.
Clinical and experimental rheumatology
|February 19, 2024
概括
中度类风湿性关节炎 (RA) 患者在开始使用生物药物时更有可能实现缓解或低疾病活性 (LDA). 严重的RA患者在疾病活动,疲劳和睡眠方面表现出更大的改善,在不同组之间药物持久性相似.
科学领域:
- 类风湿病学 类风湿病学
- 临床免疫学临床免疫学
- 药物治疗 药物治疗
背景情况:
- 类风湿性关节炎 (RA) 管理的目标是缓解或低疾病活性 (LDA).
- 生物疗法对于中度至重度的RA至关重要.
- 治疗到目标 (T2T) 策略优化治疗结果.
研究的目的:
- 评估T2T在中度和重度RA患者的实际有效性,开始使用生物药物.
- 评估生活质量 (QoL) 措施和治疗持续性.
- 为了确定与实现缓解相关的因素.
主要方法:
- 来自安大略省最佳实践研究倡议注册表 (2008-2020) 的生物无知RA患者的真实世界队列研究.
- 分析了中度 (DAS28>3.2至≤5.1) 或重度 (DAS28>5.1) RA 开始第一次生物治疗的患者.
- 包括缓解,LDA,DAS28,HAQ-DI,疲劳,睡眠和药物持续性在内的结果在12个月后被评估.
主要成果:
- 44%的中度RA相对于21%的严重RA实现了缓解 (p<0.0001);59%相对于35%达到LDA (p<0.0001).
- 严重的RA患者在DAS28,疲劳和睡眠得分中平均有更大的改善.
- 12个月后的生物持久性相似:中度RA的77%和严重RA的73%.
结论:
- 中度的RA患者更有可能实现缓解或生物启动的LDA.
- 严重的RA患者在疾病活动和QoL测量方面经历了显著的改善.
- 该研究强调了T2T的重要性,表明在现实世界实践中潜在的不足利用.
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