雅克抑制剂在先前未服用生物药物的风湿性关节炎患者中的有效性:基于人口的研究
Albert Tzu Ming Chuang1,2, Daniel Hsiang-Te Tsai1,2, Meng-Yu Weng3
1Population Health Data Center, National Cheng Kung University, Tainan, Taiwan.
Rheumatology (Oxford, England)
|April 18, 2025
概括
简氏激酶 (JAK) 抑制剂在类风湿性关节炎患者中显示出比瘤缩因子抑制剂 (TNFi) 更好的药物保留. 在JAK抑制剂和非TNFi生物药物之间,有效性是可比的,在JAK抑制剂中结果相似.
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.
- 健康 结果 研究 研究 结果
背景情况:
- 类风湿性关节炎 (RA) 管理涉及各种生物疗法.
- 没有使用过生物药的患者代表了初始治疗选择的关键人群.
- 了解药物保留是评估现实世界治疗有效性的关键.
研究的目的:
- 在RA患者中,比较Janus激酶 (JAK) 抑制剂与瘤缩因子抑制剂 (TNFi) 生物制剂和非TNFi生物制剂的有效性.
- 评估JAK抑制剂之间的类内差异.
- 评估药物保留率作为有效性的衡量标准.
主要方法:
- 一项使用台湾国家医疗保险研究数据库的队列研究.
- 包括开始使用JAK抑制剂,TNFi生物制剂或非TNFi生物制剂的RA患者.
- 在2年的时间内,使用危险比率分析治疗变化 (停止或切换) 的情况.
主要成果:
- 在16,212名患者中,16.37%接受了JAK抑制剂,62.18%接受了TNFi生物制剂,21.45%接受了非TNFi生物制剂.
- 与JAK抑制剂相比,TNFi生物药物显示治疗更改的风险更高 (HR=1.38).
- 在JAK抑制剂和非TNFi生物药物之间没有观察到治疗更改风险的显著差异.
结论:
- 与TNFi生物药物相比,JAK抑制剂在没有生物药物的RA患者中表现出更高的有效性.
- 雅克抑制剂的有效性与非TNFi生物制剂相当.
- 托法西提尼布和巴里西提尼布在JAK抑制剂类中表现出类似的有效性.
相关概念视频
The JAK-STAT Signaling Pathway
10.2K
Several cytokine receptors have tightly bound Janus kinase or JAK proteins attached at their cytosolic tail. Small signaling molecules such as cytokines, growth hormones, or prolactins bind to the cytokine receptors and initiate their dimerization. The dimerization brings the cytosolic JAKs together that trans-phosphorylate and activates each other. The activated JAKs now phosphorylate cytosolic tails of the cytokine receptors, which serve as binding sites for adaptor proteins such as SH2...
10.2K
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
780
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...
780
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
897
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...
897
Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
631
Biopharmaceutical studies constitute a vital field aiming to enhance drug delivery methods and refine therapeutic approaches, drawing upon diverse interdisciplinary knowledge. In research methodologies, the choice between controlled and non-controlled studies significantly influences the study's reliability and accuracy.
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
631
Bioavailability Study Design: Healthy Subjects Versus Patients
252
Bioavailability studies are essential for evaluating a drug's therapeutic efficacy and understanding its absorption patterns under various physiological conditions. Conducting such studies on target patient populations provides more relevant data by simulating real-world disease states. However, practical challenges often necessitate the use of young, healthy adult volunteers as study subjects.Patients may exhibit altered drug absorption patterns due to the effects of the disease itself,...
252
Bioequivalence studies: Biowaivers
433
In certain scenarios, in vitro dissolution tests can replace in vivo bioequivalence studies. This is particularly true when a drug product, though available in varying strengths, maintains proportional similarity in its active and inactive ingredients. In such cases, the need for in vivo bioequivalence studies for lower strength variants may be waived, provided dissolution tests and in vivo studies on the highest strength yield satisfactory results.Bioequivalence can be indicated through...
433


