影响关节炎患者延迟达到低疾病活性的因素 持续向治疗的关节炎患者
Yeo-Jin Song1, Soo-Kyung Cho1,2, Se Rim Choi1,2
1Hanyang University Institute for Rheumatology Research, Seoul, Korea.
The Korean journal of internal medicine
|September 8, 2025
概括
患有类风湿性关节炎 (RA) 的患者可以通过持续的向治疗来实现低疾病活性 (LDA),即使早期没有满足治疗到目标 (T2T) 标准. 这些因素包括伴随性疾病的减少和24周内疾病活动的减少.
科学领域:
- 类风湿病学 类风湿病学
- 临床免疫学临床免疫学
- 药物治疗 药物治疗
背景情况:
- 类风湿性关节炎 (RA) 管理通常采用治疗到目标 (T2T) 策略,以实现低疾病活性 (LDA).
- 然而,一些患者可能会在晚些时候实现LDA,尽管在中间时间点没有满足T2T标准.
- 了解影响延迟LDA的因素对于优化RA治疗至关重要.
研究的目的:
- 在接受向治疗的类风湿性关节炎 (RA) 患者中,确定48周达到LDA的预测因素.
- 为了探索与延迟LDA在RA患者的实现相关的因素不满足T2T标准在24周.
主要方法:
- 韩国213名RA患者接受向治疗的前性观察队列研究.
- 在48周后,根据LDA的实现,患者被分为LDA和非LDA组.
- 多变量逻辑回归分析了与延迟LDA实现相关的因素.
主要成果:
- 较少的并发症和血清阴性RA与在48周内实现LDA的可能性较低有关.
- 从入学到第24周的DAS28-ESR和HAQ-DI显著降低预测实现延迟的LDA.
- 在第24周没有使用非类固醇抗炎药物 (NSAID) 与延迟LDA的更高概率有关.
结论:
- 延迟的LDA可以在RA患者中实现,随着持续的向治疗,无论24周严格遵守T2T.
- 延迟LDA的关键因素包括较少的并发病,血清阴性状态,早期疾病活性显著降低以及在24周停止使用NSAID.
- 这些发现表明,在RA治疗中,对T2T采取更灵活的方法可能对一些患者有益.
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