在治疗类风湿性关节炎与间歇性肺病相关的治疗中使用甲索特雷克萨特:系统性审查
Ines Mahmoud1,2, Fatma Majdoub2,3, Selma Bouden1,2
1Rheumatology department, Charles Nicolle Hospital, Tunis, Tunisia.
Rheumatology (Oxford, England)
|October 29, 2025
概括
甲基 (MTX) 似乎不会增加类风湿性关节炎 (RA) 患者间歇性肺病 (ILD) 的风险. 这次系统性审查发现MTX使用与RA-ILD的发展或进展之间没有显著的关联.
科学领域:
- 类风湿病学 类风湿病学
- 肺部病理学 肺部病理学
- 药理学 药理学是指药理学的学科.
背景情况:
- 类风湿性关节炎 (RA) 是一种慢性自身免疫性疾病.
- 间歇性肺病 (ILD) 是 RA 的严重并发症.
- 甲托雷克萨特 (MTX) 是一种常见的修饰疾病的抗风湿药物 (DMARD),用于治疗 RA.
研究的目的:
- 系统地审查有关甲甲酸盐 (MTX) 暴露与风湿性关节炎 (RA) 患者间歇性肺病 (ILD) 的发展或进展的文献.
- 为了评估RA患者的肺部参与,有或没有MTX暴露.
主要方法:
- 对16项涉及36444名RA患者的研究进行了系统审查.
- 研究报告了MTX对ILD的影响作为主要或次要终点.
- 评估包括高分辨率计算机断层扫描 (HRCT),肺功能测试 (PFT),动脉血液气体分析和生存数据.
主要成果:
- 在RA患者中,MTX与发展ILD的风险增加无关 (9项研究).
- 五项研究表明,MTX与RA-ILD进展无关.
- 一项研究指出,低剂量MTX加速肺功能下降,而另一项研究将MTX与急性恶化联系起来;然而,一项研究显示,MTX使用者与非使用者之间的生存率更好.
结论:
- 甲托雷克萨特 (MTX) 似乎不会增加间歇性肺病 (ILD) 或其进展的风险在类风湿性关节炎 (RA) 患者.
- 总体证据表明,MTX与RA中肺部不良结果之间缺乏关联,尽管一些研究指出了需要进一步调查的具体问题.
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