转发性关节炎患者中断生物和向性治疗:一个回顾性队列研究
Stefka Neycheva1, Emilia Naseva2,3, Zguro Batalov4
1Department of Rheumatology, Military Medical Academy, MHAT - Sofia, 3 Sveti Georgi Sofiyski str, Sofia, 1606, Bulgaria. stneicheva@yahoo.com.
Rheumatology international
|December 23, 2024
概括
近一半的类风湿性关节炎治疗被中止. 关键因素包括缺乏疗效,副作用,男性性别,年龄较小,以及糖尿病等并发症,影响治疗策略.
科学领域:
- 类风湿病学 类风湿病学
- 临床药理学 临床药理学
背景情况:
- 类风湿性关节炎 (RA) 是一种慢性,渐进的自身免疫性疾病,需要持续管理.
- 生物和特定向的疾病修饰性抗风湿药物 (bDMARDs和tsDMARDs) 提供有效的RA治疗,但由于疗效,毒性或副作用,往往会停止使用.
研究的目的:
- 研究在保加利亚风湿性关节炎患者中停止bDMARD和tsDMARD治疗的原因和影响因素.
主要方法:
- 在12年内对154名血清阳性RA患者进行了回顾性观察队列研究.
- 分析了221个bDMARD和tsDMARD治疗疗程,以确定戒断率和相关因素.
主要成果:
- 46.6%的治疗疗程 (103/221) 被中止了.
- 主要原因包括最初缺乏疗效 (36.9%),次要缺乏疗效 (23.3%),以及不良事件/其他原因 (39.8%).
- 与停药相关的因素包括男性性别,年龄较小 (<59岁),疾病持续时间较短以及并发症 (糖尿病,脑血管疾病).
结论:
- 了解停止治疗的原因和因素对于优化当前的RA治疗策略至关重要.
- 确定患者特异性和与治疗相关的因素可以指导未来的药物开发和 RA 个性化治疗方法.
相关概念视频
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
115
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
115
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
141
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
141
Inflammatory Bowel Disease IV: Pharmacological Management
111
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...
111
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
95
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
95
Targeted Cancer Therapies
7.4K
The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against...
There are several types of targeted therapies against...
7.4K
T Cell Types and Functions
947
When T cells with CD4 markers are activated, they give rise to two types of effector cells: helper T cells and regulatory T cells. Meanwhile, T cells with CD8 markers differentiate into effector cytotoxic T cells. The differentiation of CD4 T cells into helper T cell subsets, such as Th1, Th2, and Th17 cells, is dependent on the antigen type, antigen-presenting cell, and regulatory cytokines.
Th1 cells stimulate dendritic cells to express necessary co-stimulatory molecules on their surfaces for...
Th1 cells stimulate dendritic cells to express necessary co-stimulatory molecules on their surfaces for...
947


