牛皮关节炎的生物切换:从现实世界的数据和关键风险因素的洞察
Amir Haddad1, Nili Stein2, Ilan Feldhamer3
1Rheumatology Unit, Carmel Medical Center, Haifa, Israel; Department of Epidemiology, Clalit health services, Haifa, Israel.
Seminars in arthritis and rheumatism
|April 23, 2025
概括
近一半的牛皮关节炎患者转换生物疗法,其模式受到人口统计学和并发症的影响. 尽管有新的治疗选择,但转换仍然是一致的,这突显了个性化牛皮关节炎管理的必要性.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 牛皮关节炎 (PsA) 是一种复杂的慢性炎症疾病,需要个性化治疗.
- 生物疗法对于治疗PsA至关重要,但治疗调整,包括切换,往往是必要的.
研究的目的:
- 在牛皮关节炎患者中调查切换生物修饰性抗风湿药物 (bDMARDs) 的现实世界模式.
- 识别与切换bDMARDs相关的风险因素和动作模式切换器的预测因素.
主要方法:
- 使用克拉利特医疗服务数据库 (2005-2023) 对以色列9607名PsA患者进行的回顾性队列研究.
- 分析bDMARD启动和随后的治疗切换器,并比较切换器和非切换器之间的特征.
- 切换模式的分层,按切换次数和研究周期进行分层.
主要成果:
- 在3851名开始bDMARDs的患者中,有48%的患者至少一次转换治疗.
- 抗TNF是一种常见的第一线选择,但切换到抗IL17变得普遍. 随后的开关涉及各种作用机制.
- 转换者更有可能是女性,肥胖,吸烟者,来自较低的社会经济背景,这些因素独立地与转换有关.
结论:
- 跨类生物切换在牛皮关节炎管理中很常见,影响了近一半的患者.
- 患者的人口统计和并发症显著影响切换模式.
- 随着时间的推移,切换趋势保持一致,无论治疗选择扩大.
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