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在患有青少年异常性关节炎的儿童中遵守低剂量甲状腺素,使用敏感的甲状腺素测定方法
Julia E Möhlmann1, Sytze de Roock2, Annelies C Egas3
1Department of Clinical Pharmacy, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands. j.e.mohlmann@umcutrecht.nl.
Pediatric rheumatology online journal
|May 7, 2024
概括
在使用血药物水平的青少年异常性关节炎患者中评估甲状腺素 (MTX) 坚持性,发现随着时间的推移,特别是青少年的坚持性降低了. 这种客观的方法可以帮助临床医生评估患者的坚持.
科学领域:
- 儿科风湿病学 儿科风湿病学
- 药理动力学 药理动力学
- 药物坚持 药物坚持 药物坚持
背景情况:
- 低剂量每周甲状腺素 (MTX) 是青少年异常性关节炎 (JIA) 的首要治疗方法.
- 在大量的JIA患者中,治疗效率不足可能源于药物依附率低于最佳水平.
- 对MTX遵守的客观评估对于优化JIA管理至关重要.
研究的目的:
- 通过测量血MTX度来评估青少年异常性关节炎 (JIA) 患者的甲状腺素 (MTX) 坚持.
- 调查血MTX水平与自我报告的坚持问题或同时使用生物的关系.
主要方法:
- 追溯观察性研究,涉及来自JIA患者的血样本.
- 开发一种超敏感的液体染色学-并联质谱法,用于MTX和7-氧-MTX量化.
- 将确定的血MTX度与坚持值进行比较,以将患者归类为坚持或可能不坚持的患者.
主要成果:
- 在治疗开始后不久,MTX的坚持率为88%,在分析的43名JIA患者中,在一年后降至77%.
- 青少年表现出明显更高的不坚持的风险 (p=0.002).
- 在MTX坚持和自我报告的坚持问题 (p=1.00) 或同时使用生物药物 (p=0.27) 之间没有发现显著的关联.
结论:
- 血MTX量化提供了一种可行的和客观的方法来评估对JIA的低剂量每周MTX治疗的坚持.
- 这种方法可以帮助临床医生确认或反驳疑似的不遵守.
- 随着时间的推移,坚持性会下降,这凸显了对JIA患者持续监测的需要.
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