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关于治疗持久性的现实数据以及在使用上达西提尼布的风湿患者中尽量减少心血管风险的措施
M Vanesa Hernández-Hernández1, Alicia García-Dorta1, Cristina Rodríguez-Regalado2
1Division of Rheumatology, Hospital Universitario de Canarias, La Laguna, Spain.
Rheumatology (Oxford, England)
|October 24, 2025
概括
在此前接受过interleukin-6抑制剂 (IL-6i) 治疗的类风湿性关节炎患者中,upadacitinib (UPA) 的持久性较低. 心血管风险 (CVR) 管理影响了UPA的处方模式,主要是安全研究而不是监管指导.
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.
- 临床研究 临床研究
背景情况:
- 乌帕达西替尼 (UPA) 是一种Janus激酶抑制剂 (JAKi),它携带有关心血管风险 (CVR) 和恶性瘤的监管警告.
- 了解影响UPA治疗持续性的因素对于优化患者在现实环境中的治疗结果至关重要.
研究的目的:
- 确定与UPA治疗持久性相关的临床和人口因素.
- 评估CVR安全建议对UPA处方模式的影响.
主要方法:
- 这是一项对306名类风湿性关节炎 (RA) 和脊椎关节炎 (SpA) 患者的多中心观察研究.
- 从2021年1月到2023年12月的UPA (n=153) 与TNF抑制剂 (TNFi,n=153) 的比较.
- 使用卡普兰-梅尔曲线和考克斯回归分析UPA持久性;随着时间的推移评估CVR变化.
主要成果:
- 在RA (23.9个月) 和SpA (22.8个月) 患者中观察到类似的UPA持久性.
- 之前使用插白素-6抑制剂 (IL-6i) 与 RA 患者的 UPA 持久性降低有关 (HR:2.05,p=0.008).
- 在2022年2月之后开始UPA的患者与开始TNFi的患者相比,基线CVR显著较低 (p=0.042).
结论:
- 在先前暴露于IL-6i的RA患者中,UPA持久性降低.
- 关于CVR的现实世界UPA处方模式似乎受到关键安全数据的影响,而不是仅仅是监管指令.
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