Lisbona Maria Pilar, Maymo Joan, Perich Javier, Almirall Miriam, Pérez-García Carolina, Carbonell Jordi
Department of Rheumatology, IMAS, Hospital del Mar, Barcelona, Spain.
J Rheumatol. 2008 Mar;35(3):394-7. Epub 2008 Jan 15.
To demonstrate the efficacy of etanercept to reduce synovitis as measured by magnetic resonance imaging (MRI) as early as 6 weeks after starting treatment in patients with active rheumatoid arthritis (RA).
Twenty-two patients with active RA despite disease modifying antirheumatic drug (DMARD) treatment were included in this prospective, controlled study. Patients were randomized in 2 groups. In the treatment group, etanercept was added at usual doses during 6 weeks. In the control group, patients continued with prior DMARD therapy. MRI of the dominant wrist and 2nd-5th MCP joints were obtained at baseline and at 6 weeks and evaluated according to OMERACT recommendations. Results of changes in synovitis in the treatment group were compared with changes in the control group.
Changes in synovitis measured by MRI of the hand (OMERACT evaluation) in the etanercept group showed a significant reduction after 6 weeks of treatment compared with no changes in the control group. Reduction of synovitis in the treatment group also showed good correlation with decrease of various clinical and laboratory measures.
In patients with active RA despite DMARD therapy, etanercept, but not placebo, reduced synovitis as measured by MRI after 6 weeks.
通过磁共振成像（MRI）证明，对于活动性类风湿关节炎（RA）患者，在开始治疗6周后，依那西普减轻滑膜炎的疗效。
本前瞻性对照研究纳入了22例尽管接受了改善病情抗风湿药物（DMARD）治疗但仍患有活动性RA的患者。患者被随机分为两组。治疗组在6周内按常规剂量加用依那西普。对照组患者继续接受先前的DMARD治疗。在基线和6周时对优势手腕和第2 - 5掌指关节进行MRI检查，并根据OMERACT推荐进行评估。将治疗组滑膜炎的变化结果与对照组的变化进行比较。
依那西普组手部MRI测量的滑膜炎变化（OMERACT评估）显示，治疗6周后与对照组无变化相比有显著降低。治疗组滑膜炎的减轻也与各种临床和实验室指标的下降有良好的相关性。
对于尽管接受了DMARD治疗但仍患有活动性RA的患者，依那西普而非安慰剂在6周后通过MRI测量可减轻滑膜炎。
