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Ann Rheum Dis：传统DMARD联用泼尼松龙诱导缓解有效且可达5年

2014-11-05 翻译杜卉 中国医学论坛报

早期类风湿关节炎患者传统DMARD联用泼尼松龙诱导缓解有效达5年
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芬兰学者研究发现，联用传统缓解病情抗风湿药(DMARD)和泼尼松龙可使大多数早期类风湿关节炎(RA)患者达到诱导缓解和最大程度地抑制影像学进展，这些效果可达5年;起始治疗时加用英夫利西单抗6个月并不进一步改善上述结果。论文发表于《风湿病年鉴》(Ann Rheum Dis 2014，73：1954)杂志。 研究纳入99例早期、未曾使用DMARD的RA患者，起始治疗时均给予甲氨蝶呤(最大剂量

芬兰学者研究发现，联用传统缓解病情抗风湿药(DMARD)和泼尼松龙可使大多数早期类风湿关节炎(RA)患者达到诱导缓解和最大程度地抑制影像学进展，这些效果可达5年;起始治疗时加用英夫利西单抗6个月并不进一步改善上述结果。论文发表于《风湿病年鉴》(Ann Rheum Dis 2014，73：1954)杂志。

研究纳入99例早期、未曾使用DMARD的RA患者，起始治疗时均给予甲氨蝶呤(最大剂量为25mg/w)、柳氮磺胺吡啶(最大剂量为2g/d)和羟氯喹[35mg/(kg/w)]三种DMARD以及泼尼松龙(7.5mg/d)治疗，并在起始治疗的6个月内被随机分为英夫利西单抗(3mg/kg)或安慰剂治疗组。评估治疗5年后的临床和影像学进展情况。

结果为，有91例患者完成了5年的随访，英夫利西组和安慰剂组分别为45和46例。在5年时，两组患者达到严格美国风湿病学会(ACR)缓解标准和28个关节疾病活动性评分改善的比例分别为60%和61%、84%和89%;相应的总夏普/范德海登(Sharp/van der Heijde)评分分别为4.3和5.3，自基线至5年时该评分的平均改变分别为1.6和3.7(P=0.13)。


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  1. [GetPortalCommentsPageByObjectIdResponse(id=2011917, encodeId=689f201191eec, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Sun Jan 11 17:09:00 CST 2015, time=2015-01-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1553882, encodeId=420f1553882e0, content=<a href='/topic/show?id=adbe650e465' target=_blank style='color:#2F92EE;'>#泼尼松龙#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65074, encryptionId=adbe650e465, topicName=泼尼松龙)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fb4914457810, createdName=xjy07, createdTime=Fri Nov 07 05:09:00 CST 2014, time=2014-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1587606, encodeId=c65d158e606f6, content=<a href='/topic/show?id=d6706042a3' target=_blank style='color:#2F92EE;'>#DMARD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6042, encryptionId=d6706042a3, topicName=DMARD)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=94e417527720, createdName=whlxd, createdTime=Fri Nov 07 05:09:00 CST 2014, time=2014-11-07, status=1, ipAttribution=)]
    2015-01-11 cmj8wellington

    #Dis#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=2011917, encodeId=689f201191eec, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Sun Jan 11 17:09:00 CST 2015, time=2015-01-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1553882, encodeId=420f1553882e0, content=<a href='/topic/show?id=adbe650e465' target=_blank style='color:#2F92EE;'>#泼尼松龙#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65074, encryptionId=adbe650e465, topicName=泼尼松龙)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fb4914457810, createdName=xjy07, createdTime=Fri Nov 07 05:09:00 CST 2014, time=2014-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1587606, encodeId=c65d158e606f6, content=<a href='/topic/show?id=d6706042a3' target=_blank style='color:#2F92EE;'>#DMARD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6042, encryptionId=d6706042a3, topicName=DMARD)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=94e417527720, createdName=whlxd, createdTime=Fri Nov 07 05:09:00 CST 2014, time=2014-11-07, status=1, ipAttribution=)]
    2014-11-07 xjy07

    #泼尼松龙#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=2011917, encodeId=689f201191eec, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Sun Jan 11 17:09:00 CST 2015, time=2015-01-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1553882, encodeId=420f1553882e0, content=<a href='/topic/show?id=adbe650e465' target=_blank style='color:#2F92EE;'>#泼尼松龙#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65074, encryptionId=adbe650e465, topicName=泼尼松龙)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fb4914457810, createdName=xjy07, createdTime=Fri Nov 07 05:09:00 CST 2014, time=2014-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1587606, encodeId=c65d158e606f6, content=<a href='/topic/show?id=d6706042a3' target=_blank style='color:#2F92EE;'>#DMARD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6042, encryptionId=d6706042a3, topicName=DMARD)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=94e417527720, createdName=whlxd, createdTime=Fri Nov 07 05:09:00 CST 2014, time=2014-11-07, status=1, ipAttribution=)]
    2014-11-07 whlxd

    #DMARD#

    0