与难以治疗的风湿性关节炎 (D2T-RA) 相关的因素:来自单中心横截面研究的现实世界证据.
Maurizio Benucci1, Francesca Li Gobbi1, Emanuele Antonio Maria Cassarà1
1Rheumatology Unit, S. Giovanni di Dio Hospital, Azienda USL Toscana Centro, 50143 Florence, Italy.
Journal of personalized medicine
|February 26, 2026
概括
难以治疗的类风湿性关节炎 (D2T-RA) 与女性性别,更长的疾病持续时间和更高的炎症标志物有关. 雅克抑制剂在稳定其他治疗失败的D2T-RA患者方面表现有前途.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 临床医学 临床医学
背景情况:
- 类风湿性关节炎 (RA) 是一种慢性自身免疫性疾病,导致关节炎症和破坏.
- 尽管有诸如治疗到标 (T2T) 和生物/向合成疾病修饰抗风湿药 (b/tsDMARDs) 等进展,但许多患者患有耐药性疾病.
- 难以治疗的类风湿性关节炎 (D2T-RA) 是由EULAR在2021年定义的,用于描述这种持续活跃的RA.
研究的目的:
- 确定与D2T-RA相关的临床,实验室和治疗因素.
- 了解区分D2T-RA与非D2T-RA患者的特征.
- 探索D2T-RA中的治疗模式和结果.
主要方法:
- 对344名已确诊的RA患者进行了回顾性分析.
- 根据2021年EULAR标准对D2T (164名患者) 和NO-D2T (180名患者) 组进行分类.
- 对临床,实验室,临床测量和治疗数据的分析.
主要成果:
- D2T-RA与女性性别,更长的疾病持续时间,更高的类风湿因子 (RF) 和抗素蛋白抗体 (ACPA) 标位,较高的红细胞沉积率 (ESR),葡萄糖皮质类药物使用以及更多未成功的先进疗法有关.
- 两组人都通过DAS28和CDAI实现了低疾病活性或缓解.
- JAK抑制剂,特别是Filgotinib和Upadacitinib,在D2T队列中更常见,并且与临床稳定有关.
结论:
- 疾病的慢性和持续的炎症是发展RA治疗耐药性的关键因素.
- 这项研究确定了D2T-RA.的预测概况.
- 雅克抑制剂显示出稳定D2T-RA患者耐常规和生物DMARDs耐药性的潜力,解决未满足的需求.
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