类风湿性关节炎的甲索特雷克萨特治疗策略:对剂量和施用途径的范围审查
Esteban Rubio-Romero1, César Díaz-Torné2, María José Moreno-Martínez3
1Department of Rheumatology, Hospital Universitario Virgen del Rocío, Seville, Spain. cybereste@gmail.com.
BMC rheumatology
|March 5, 2024
概括
较高的初始剂量和皮下注射甲状腺素 (MTX) 改善了类风湿性关节炎 (RA) 患者的治疗反应. 在考虑治疗失败之前,建议优化MTX剂量和途径.
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.
- 临床试验 临床试验
背景情况:
- 甲托雷克萨特 (MTX) 是类风湿性关节炎 (RA) 的基石疗法.
- 对非响应者的最佳启动策略和剂量/路线优化需要进一步的证据.
- 了解MTX的有效性和安全性对于有效的RA管理至关重要.
研究的目的:
- 审查RA患者MTX启动策略的证据.
- 分析MTX不响应者路线和剂量优化的疗效和安全性.
主要方法:
- 随机对照试验的综合范围审查.
- 在PubMed,EMBASE和Cochrane数据库中进行的搜索.
- 接下来是PRISMA范围审查检查清单和阿克西和奥马利框架.
主要成果:
- 较高的MTX初始剂量 (25mg vs 15mg) 显示出更高的疗效与更多的缓解.
- 皮下 (SC) MTX的ACR20反应率 (85%) 比口服MTX (77%) 高.
- 逐步增加剂量和SC MTX优化改善了非响应者的结果.
结论:
- 较高的MTX初始剂量和初始SC剂量在RA中增强了ACR20反应.
- 在认为治疗无效之前,优化MTX剂量和途径得到证据的支持.
- 优化MTX治疗为RA患者提供了更好的治疗结果.
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