Division of Rheumatology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
Mod Rheumatol. 2012 Jun;22(3):327-38. doi: 10.1007/s10165-011-0516-6. Epub 2011 Sep 7.
We retrospectively investigated the ability of adalimumab (ADA) to reduce disease activity, improve physical function, and retard the progression of structural damage in 167 patients with rheumatoid arthritis. Clinical and functional outcomes were compared between patients with or without prior biologic treatment and those with or without concomitant methotrexate (MTX) treatment. At week 52, 38.3% achieved clinical remission: 42.4 and 28.6% of patients achieved remission in those without and with previous biologics, respectively, while 42.7 and 12.5% of patients achieved remission in those with and without concomitant MTX, respectively. ADA treatment significantly reduced the rate of radiographic progression from 27.1 ± 46.0 (median 13.6; 25th-75th percentiles 8.3 to 28.9) at baseline to 0.8 ± 5.0 (median 0.0; 25th-75th percentiles -0.9 to 2.0) at week 52 (P < 0.0001). Radiographic progression was absent in 59.8% of patients. Sixty adverse events (34.21/100 patient-years) were reported, 16 of which were serious (9.12/100 patient-years). ADA therapy is highly effective for reducing disease activity, improving physical function, and limiting radiographic progression. It is generally safe and well tolerated by Japanese RA patients in routine clinical practice.
我们回顾性研究了阿达木单抗(ADA)在 167 例类风湿关节炎患者中降低疾病活动度、改善躯体功能和延缓结构损伤进展的能力。比较了既往有生物治疗和无生物治疗、同时有和无甲氨蝶呤(MTX)治疗患者的临床和功能结局。在第 52 周,38.3%的患者达到临床缓解:既往无生物治疗和有生物治疗患者的缓解率分别为 42.4%和 28.6%,而同时有和无 MTX 治疗患者的缓解率分别为 42.7%和 12.5%。ADA 治疗显著降低了放射学进展的速度,从基线时的 27.1±46.0(中位数 13.6;25 分位数至 75 分位数 8.3 至 28.9)降至第 52 周的 0.8±5.0(中位数 0.0;25 分位数至 75 分位数 -0.9 至 2.0)(P<0.0001)。59.8%的患者无放射学进展。报告了 60 例不良事件(34.21/100 患者年),其中 16 例为严重不良事件(9.12/100 患者年)。ADA 治疗对于降低疾病活动度、改善躯体功能和限制放射学进展非常有效。在日本 RA 患者的常规临床实践中,ADA 治疗通常安全且耐受良好。