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生物疗法治疗临床实践中的银屑病关节炎:2 年的结果。

Biological therapy for psoriatic arthritis in clinical practice: outcomes up to 2 years.

机构信息

University of Helsinki, Finland.

出版信息

J Rheumatol. 2010 Nov;37(11):2362-8. doi: 10.3899/jrheum.091477. Epub 2010 Aug 17.

Abstract

OBJECTIVE

To evaluate the performance of biological drugs in psoriatic arthritis (PsA) in a routine care setting, using the Finnish national register of biological treatment (ROB-FIN).

METHODS

Patients with PsA who started therapy with infliximab or etanercept between June 2000 and February 2006 (n = 127) were followed for up to 24 months. Response was evaluated using American College of Rheumatology response criteria including individual measures.

RESULTS

Significantly diminished values for swollen and tender joints, patient's global and pain assessments, doctor's global assessment of disease activity, erythrocyte sedimentation rate, C-reactive protein, and Health Assessment Questionnaire score were observed within 3 months after commencement of both infliximab and etanercept. Values remained significantly lower throughout the 24 months of followup. ACR20 response at 3 months was 79% (n = 22/28) for infliximab and 76% (n = 34/45) for etanercept. The first biological drug was discontinued in 16% due to lack of effectiveness and in 6% due to adverse events.

CONCLUSION

Anti-tumor necrosis factor-α therapy, often combined with conventional disease-modifying antirheumatic drugs, appeared to have limited toxicity and persistent effectiveness for up to 2 years in a cohort of Finnish patients with severe peripheral PsA.

摘要

目的

利用芬兰国家生物治疗登记处(ROB-FIN)评估常规护理环境中生物药物在银屑病关节炎(PsA)中的疗效。

方法

2000 年 6 月至 2006 年 2 月期间,127 例接受英夫利昔单抗或依那西普治疗的 PsA 患者接受了长达 24 个月的随访。使用美国风湿病学会反应标准(包括个体指标)评估反应。

结果

在开始使用英夫利昔单抗和依那西普后的 3 个月内,肿胀和压痛关节、患者的整体和疼痛评估、医生对疾病活动的整体评估、红细胞沉降率、C 反应蛋白和健康评估问卷评分均显著降低。在整个 24 个月的随访过程中,这些数值持续保持较低水平。在 3 个月时,英夫利昔单抗的 ACR20 反应率为 79%(22/28),依那西普的反应率为 76%(34/45)。由于疗效不佳,16%的患者首次停用生物药物,6%的患者因不良反应停用。

结论

在芬兰重度外周型 PsA 患者队列中,抗 TNF-α 治疗(通常与传统的疾病修饰抗风湿药物联合使用)似乎具有有限的毒性和长达 2 年的持续疗效。

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