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[对轴性脊柱关节炎的放射性进展进行头对头研究]

Uta Kiltz^1,2, Hildrun Haibel³

¹Ruhr-Universität Bochum, Bochum, Deutschland. uta.kiltz@elisabethgruppe.de.

Zeitschrift fur Rheumatologie

|May 21, 2024

概括

对轴性关节炎 (axSpA) 的治疗方法进行比较,头对头的研究表明,在阿达利穆马布生物类似疾病修饰性抗风湿药物 (bsDMARDs) 和secukinumab之间,脊椎放射性进展没有显著差异. 其他研究表明,生物DMARDs (bDMARDs) 与非类固醇抗风湿药 (NSARDs) 相比,具有更高的临床疗效.

科学领域:

类风湿病学类风湿病学
免疫学免疫学免疫学
临床医学临床医学

背景情况:

轴性脊柱性关节炎 (axSpA) 是一种影响脊柱的慢性炎症状况.
了解不同治疗策略的比较疗效对于管理axSpA至关重要.
放射性进展和临床疗效是评估axSpA治疗的关键终点.

研究的目的:

审查和讨论关于轴性脊柱炎 (axSpA) 的四项临床比较研究的发现.
为了比较不同疾病修饰性抗风湿药物 (DMARDs) 对axSpA的放射性进展和临床结果的影响.
评估生物DMARDs (bDMARDs) 与非类固醇抗风湿药物 (NSARDs) 和传统合成DMARDs (csDMARDs) 的疗效.

主要方法:

在 axSpA.A. 中对四项临床比较研究的综述.
分析了SURPASS对比研究,比较了在2年内进行的阿达利穆马布bsDMARD和塞库金乌马布的分析.
检查了三项非对比性研究,比较了使用bDMARD和不使用bDMARD的NSARD (戈利马布,伊坦塞普特,因弗利西马布).
包括来自CONSUL,ESTHER和INFAST研究的数据,在适用的情况下使用全身MRI.

主要成果:

在SURPASS研究中,发现脊柱的放射性进展较低,在阿达利穆马布bsDMARD和secukinumab之间没有显著差异.
在CONSUL研究中,联合戈利木巴和赛莱科克西布与单独戈利木巴之间的放射性进展延迟没有显著差异.
该ESTHER研究表明,在早期 axSpA 与活跃的炎症病变中,乙素优于硫法萨拉辛.
在INFAST研究中,联合使用infliximab和naproxen在早期活跃axSpA患者中,导致临床缓解率高于单独使用naproxen.
在研究的作用机制之间,在抑制放射性进展方面没有观察到任何差异.
与NSAR或csDMARD相比,bDMARD显示出明显更好的临床疗效反应.

结论:

对于axSpA的放射性进展,当前的比较研究表明,研究的作用机制之间没有显著差异.
在 axSpA.中,生物DMARDs (bDMARDs) 与非类固醇抗风湿药物 (NSARDs) 或常规合成DMARDs (csDMARDs) 相比,具有更高的临床疗效.
进一步的对比试验对于确定特定病原体及其对疾病进展和患者结果的影响有价值.

关键词:

生物疾病修饰抗风湿药物生物疾病修饰抗风湿药物进行比较性研究.传统的合成修饰疾病的抗风湿药物.非类固醇抗风湿药物非类固醇抗风湿药物对治疗的反应.

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