首页 我的

转载 强直性脊柱炎患者使用依那西普治疗的长期药物安全性和疗效

郭强 主任医师 仁济医院 风湿病科
2017-01-25 1086人已读
郭强 主任医师
仁济医院
01.jpg

在日常临床实践中,强直性脊柱炎患者使用依那西普治疗的长期药物安全性和临床疗效上海交通大学医学院附属仁济医院风湿病科郭强

摘要

目的

随机对照试验和开放标签延伸研究已经证实在预选研究的强直性脊柱炎(AS)患者中,肿瘤坏死因子-α(TNF-α)阻断疗法具有临床疗效和安全性。我们的目的是调查在临床实践中,依那西普治疗AS患者的7年药物使用安全性和临床疗效。 

方法

来自一项前瞻性观察性GLAS队列、且由于疾病活动而开始使用依那西普的、并连续入组的AS患者被纳入研究。根据一个固定的研究方案,对入组患者进行为期7年的评估。治疗是否继续是基于BASDAI改善和/或专家意见。

结果

在包括AS患者在内的89例中,45例(51%)在7年的随访中仍然使用依那西普。治疗停止的原因是不良事件(n = 22)、无效(n = 13)或其他原因,虽然治疗的临床应答良好(n = 9)。依那西普治疗导致疾病活动(BASDAI,ASDAS,CRP,医生GDA)、脊柱运动、身体功能(BASFI)、生活质量(ASQoL)和脊柱外表现(关节肿胀,关节和附着点压痛)出现快速(6周后)和持续的改善。此外,在随访期间,依那西普联用NSAID或DMARD显著减少。在治疗第7年,45例患者的低疾病活动度和缓解率分别为67-73%和29-30%。在停用依那西普的患者中,18例在随访期间切换成第二或第三种TNF-α阻滞剂。

结论

在一个用依那西普治疗的大型AS患者队列中,约50%患者继续依那西普治疗达7年。我们对临床终点的广泛评估证明,在日常临床实践中依那西普具有长期疗效。 

原文

Long-term drug survival and clinical effectiveness of etanercept treatment in patients with ankylosing spondylitis in daily clinical practice.

Abstract

Objective:

Randomised controlled trials and open-label extension studies have demonstrated the clinical efficacy and safety of tumour necrosis factor-alpha (TNF-α) blocking therapy in pre-selected study patients with ankylosing spondylitis (AS). Our aim was to investigate the 7-year drug survival and clinical effectiveness of etanercept treatment in AS patients in daily clinical practice.

Methods:

Consecutive AS patients from the prospective observational GLAS cohort who started etanercept because of active disease were included and evaluated over 7 years according to a fixed protocol. Continuation of treatment was based on BASDAI improvement and/or expert opinion.

Results:

Of the 89 included AS patients, 45 (51%) were still using etanercept at 7 years of follow-up. Reasons for treatment discontinuation were adverse events (n=22), inefficacy (n=13), or other reasons although good clinical response (n=9). Etanercept treatment resulted in a rapid (after 6 weeks) and sustained improvement in disease activity (BASDAI, ASDAS, CRP, physician GDA), spinal mobility, physical function (BASFI), quality of life (ASQoL), and extra-spinal manifestations (swollen joints, tender joints and tender entheses). Furthermore, concomitant NSAID or DMARD use decreased significantly during follow-up. At 7 years, low disease activity and remission were present in 67-73% and 29-30% of the 45 patients, respectively. Of the patients who discontinued etanercept, 18 switched successfully to a second or third TNF-α blocker during follow-up.

Conclusion:

In a large cohort of AS patients treated with etanercept, approximately 50% continued this treatment for 7 years. Our broad evaluation of clinical endpoints proves the long-term effectiveness of etanercept treatment in daily clinical practice.

02.jpg

来源:中华风湿

本文为转载文章,如有侵权请联系作者删除。

有帮助
期待更新

郭强 主任医师

仁济医院 风湿病科

问医生 去挂号

更多文章

强直性脊柱炎患者使... 的相关咨询
强直性脊柱炎患者使... 的相关疾病
由于相关规范,IOS用户暂不可在小程序订阅