患者的单中心横截面分析:来自处方数据库的数据
Maurizio Benucci1, Francesca Li Gobbi1, Emanuele Antonio Maria Cassarà1
1Rheumatology Unit, S. Giovanni di Dio Hospital, USL-Toscana-Centro, 50143 Florence, Italy.
Journal of personalized medicine
|August 27, 2025
概括
这项研究评估了类风湿性关节炎 (RA),脊椎关节炎 (SpA) 和牛皮关节炎 (PsA) 的现实生物治疗处方,发现ITABIO的建议指导了适当的治疗选择. 风湿性关节炎,特别难以治疗的病例,显示显著的治疗失败.
科学领域:
- 关节病学
- 免疫学
- 药理学
背景情况:
- 意大利定制生物疗法委员会 (ITABIO) 之前对RA,SPA和PsA的最佳二线生物疗法进行了文献审查.
- 开发了一个现实数据库,以评估ITABIO建议的遵守情况及其对炎症性关节炎患者健康状况的影响.
研究的目的:
- 验证ITABIO对RA,SPA和PSA的二线生物治疗建议的实际应用.
- 评估生物处方的适当性及其在维持患者健康状况方面的有效性.
主要方法:
- 对616名RA,SpA或PsA患者进行了回顾性分析.
- 评估患者的人口结构,诊断,治疗史 (csDMARDs,bDMARDs,tsDMARDs) 和并发症 (CV风险因素,肝病,感染,瘤,糖尿病).
- 评估关节外表现,包括间歇性肺病 (ILD),肠炎,甲状腺炎,脑膜炎,炎症性肠病,以及类风湿因子 (RF) /抗素抗体 (ACPA) 针对RA.
主要成果:
- 抗TNF生物类似药的使用率有所不同:SPA为65. 1%,PSA为52. 4%,RA为24. 3%.
- 单一治疗是普遍存在的 (总体为68%). 对于RA,34. 2%是难以治疗的 (D2T),其中54. 8%是单一治疗 (例如,托西利祖马布,乌帕达西提尼布).
- 对于RF/ ACPA阳性RA和ILD患者来说,Abatacept是最受欢迎的. 根据疾病特征和并发症,sequinumab,ixekizumab和apremilast等特定疗法在SpA和PsA中被针对性地使用.
结论:
- 横截面分析证实ITABIO的建议有效指导RA,SPA和PsA的适当生物处方.
- 风湿性关节炎,特别是D2T-RA,是最重要的治疗挑战,其特点是单一治疗和MTX停止的高率.
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