一年一次随机双盲安慰剂对照试验的结果,该试验为最近被诊断为多发性肌痛性风湿性肌痛患者每周服用25毫克的甲状腺素
Thomas E Bolhuis1, Noortje E S E P Kooijman1, Diane E Marsman2
1Department of Rheumatology, Sint Maartenskliniek, Ubbergen, The Netherlands; Radboudumc Graduate School, Radboud University Medical Center, Nijmegen, The Netherlands.
Annals of the rheumatic diseases
|December 21, 2025
概括
高剂量的甲状腺素 (25毫克/周) 显著改善了多发性肌痛风湿症 (PMR) 患者的无葡萄糖皮质类药物缓解. 在PMR中早期引入甲状腺素,为实现持续缓解提供了巨大的好处.
科学领域:
- 类风湿病学 类风湿病学
- 临床试验 临床试验
- 药理学 药理学是指药理学的学科.
背景情况:
- 甲托雷克萨特是一种推的第一线葡萄糖皮质醇节约剂,用于多发性肌痛类风湿性疼痛 (PMR).
- 之前的试验使用了低剂量的甲状腺素 (7.5-10毫克/周),结果相互矛盾.
- 在PMR中使用更高的甲状腺素剂量 (25毫克/周) 的证据有限.
研究的目的:
- 评估高剂量甲状腺素酸盐 (25毫克/周) 在新诊断的PMR患者中实现无葡萄糖皮质醇缓解的疗效.
- 为了在随机对照试验 (RCT) 环境中比较高剂量的甲状腺素和安慰剂.
主要方法:
- 一个52周的,盲目的,安慰剂控制的RCT.
- 最近被诊断为PMR的患者接受了25毫克/周的甲醇或安慰剂.
- 实施了一项为期 24 周的糖皮质激素减缓方案.
主要成果:
- 在52周后,80%的接受甲状腺素治疗的患者获得了无葡萄糖皮质激素缓解,而安慰剂患者的比例为46%.
- 这代表了34%的显著风险差异 (一边P=.0042).
- 该研究最终分析了58名患者.
结论:
- 25毫克/周的甲托雷克萨特显著增加了新诊断的PMR中无葡萄糖皮质类药物缓解的可能性.
- 早期引入甲托雷克萨特在PMR管理中显然有好处.
- 需要进行进一步的研究,以优化PMR治疗中甲状腺素开端的时间.
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