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在upadacitinib后的类风湿性关节炎患者的侵蚀回归 - - 一项使用高分辨率外围定量计算断层扫描的试点研究

Ho So¹, Isaac Cheng¹, Evelyn Chow¹

¹Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China.

Rheumatology (Oxford, England)

|September 17, 2024

概括

优达丁尼布对Janus kinase (JAK) 1的抑制显示,在类风湿性关节炎 (RA) 患者中,具有修复骨质侵蚀的潜力. 需要对侵蚀修复的JAK1抑制进行进一步的研究.

科学领域:

类风湿病学类风湿病学
免疫学免疫学免疫学
整形外科整形外科整形外科

背景情况:

类风湿性关节炎 (RA) 是一种慢性自身免疫性疾病,其特点是关节炎症和骨质侵蚀.
高分辨率外围定量CT (HR-pQCT) 是评估RA骨质侵蚀的关键成像方式.
简氏激酶 (JAK) 抑制剂已经成为一种有前途的治疗类型.

研究的目的:

调查Janus激酶 (JAK) 1抑制对活跃类风湿性关节炎 (RA) 患者骨质侵蚀修复的影响.
通过使用高分辨率的外周定量CT (HR-pQCT) 评估治疗后骨质侵蚀体积的变化.
评估上达西提尼布治疗与侵蚀回归之间的关联,考虑疾病活性和持续时间.

主要方法:

一项前性非随机试点研究,涉及20名在HR-pQCT上活跃的RA和骨质侵蚀的成年患者.
患者在24周内每天服用一次15毫克的阿帕达西提尼布,在基线和24周进行HR-pQCT.
为了进行比较,包括了20名RA患者的活性对照组,这些患者接受了常规合成修饰疾病的抗风湿药物 (csDMARDs) 治疗.

主要成果:

与csDMARDs对照组相比,upadacitinib治疗导致侵蚀体积减少的趋势 (-0.23 mm3对1.32 mm3).
在接受上达西提尼布治疗的患者中,更高比例的患者表现出侵蚀回归 (27%与12%相比).
在根据疾病持续时间进行调整后,upadacitinib的使用与侵蚀回归 (OR:3.61,P = 0.049) 有显著的关联,骨再吸收标志物减少.

结论:

与csDMARDs相比,upadacitinib在RA患者的HR-pQCT上显示出骨质侵蚀的差异回归,尽管疾病活性有类似的改善.
这些发现表明,JAK1抑制在促进RA骨质侵蚀修复方面可能发挥作用.
建议进行进一步的研究,以探索JAK1抑制对类风湿性关节炎骨质侵蚀的治疗潜力.

关键词:

HRpQCT 的使用方法杰基 (Jakii) 是一个名字.拉拉拉拉拉拉拉拉拉拉拉拉拉侵蚀修复侵蚀修复这种药物是upadacitinib.

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