评估莱夫卢诺米德和甲甲酸组合与单疗法在类风湿性关节炎和牛皮性关节炎
Mete Kara1, Gülay Alp2, Mete Pekdiker3
1Department of Rheumatology, İzmir City Hospital, İzmir, Turkiye.
Turkish journal of medical sciences
|July 21, 2025
概括
结合甲状腺素 (MTX) 和 leflunomide (LEF) 为风湿性关节炎 (RA) 和牛皮性关节炎 (PsA) 提供了安全有效的治疗方法. 这种组合疗法显示出更好的疗效,减少了对其他先进治疗的需求.
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.
- 临床医学 临床医学
背景情况:
- 甲托雷克萨特 (MTX) 和莱夫卢诺米德 (LEF) 是常见的修改疾病的抗风湿药物 (DMARD) 用于类风湿性关节炎 (RA) 和牛皮性关节炎 (PsA).
- 这些药物作为单一疗法或组合使用,具有不同的疗效和安全性.
研究的目的:
- 为了比较联合MTX加LEF治疗与RA和PSA患者单一治疗的不良反应 (AE) 和疗效.
- 在这些治疗方案下确定RA和PsA患者低疾病活性 (LDA) 的预测因子.
主要方法:
- 一项涉及528名患者 (385名RA,143名PsA) 的研究,至少进行6个月的随访.
- 使用DAS-28 CRP和DAPSA评估疾病活动;使用MedDRA分类分类的AE.
- 统计分析包括单变量和多变量分析,以确定LDA的预测因素.
主要成果:
- 累计的AE发生率各不相同:RA (MTX 23.8%,LEF 28.2%,MTX+LEF 19.2%);PSA (MTX 18.1%,LEF 30%,MTX+LEF 23.3%). 这两种情况都存在.
- 与单疗法相比,MTX加LEF在RA和PSA中表现出疾病活性,葡萄糖皮质激素剂量和生物/向DMARDs (b/tsDMARDs) 使用的优异降低.
- 在RA中LDA的预测因素包括MTX剂量和初始DAS28-CRP;在PsA中,疾病持续时间是独立的预测因素.
结论:
- 结合治疗MTX加LEF是一种有价值,安全和有效的RA和PsA的替代方案.
- 这种组合在生物/向DMARD治疗不可行或具有挑战性时特别有用.
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