Department of Orthopaedic Surgery, Kansai Medical University,Hirakata, Osaka , Japan.
Mod Rheumatol. 2012 Nov;22(6):824-30. doi: 10.1007/s10165-011-0591-8.
The twice-weekly administration of 25 mg of etanercept (TW) has been shown to be effective in patients with rheumatoid arthritis (RA). However, the once-weekly administration of 25 mg of etanercept (OW) was tried in order to address the economic burden of anti-rheumatic biologics. We evaluated the clinical and radiographic results from a 2-year follow-up study of patients receiving OW or TW.
Sixty-three biologics-naive patients with RA were randomly assigned to receive either OW (n = 42) or TW (n = 21).
From baseline to year 2, rates of clinical remission,according to the Disease Activity Score of 28 joints(DAS-28) (based on C-reactive protein; CRP)–with clinical remission being regarded as a DAS-28 (CRP) score of\2.3–were significantly improved in the OW group (from 1.6 to 39.0%) and in the TW group (from 9.5 to 47.6%),but no significant between-group difference was observed at year 2. Radiographic joint damage, quantified with the modified Sharp score, was significantly progressive in the OW group in contrast to findings in the TW group. Thus,among patients receiving TW therapy, the progression of joint damage may have been inhibited or may have shown remission.
These results suggest that, in terms of DAS-28 remission, OW therapy can efficiently substitute for TW therapy in biologics-naive patients with RA. However, TW therapy was indispensable in preventing the worsening of joint damage.
每周两次给予 25 毫克依那西普(TW)的治疗方案已被证明对类风湿关节炎(RA)患者有效。然而,为了减轻抗风湿生物制剂的经济负担,尝试了每周一次给予 25 毫克依那西普(OW)的治疗方案。我们评估了接受 OW 或 TW 治疗的患者进行为期 2 年的随访研究的临床和影像学结果。
63 名生物制剂初治的 RA 患者被随机分配接受 OW(n=42)或 TW(n=21)治疗。
从基线到第 2 年,OW 组(从 1.6%到 39.0%)和 TW 组(从 9.5%到 47.6%)的临床缓解率(根据 C 反应蛋白(CRP)校正的 28 个关节疾病活动度评分[DAS-28],临床缓解定义为 DAS-28[CRP]评分\2.3)均显著改善,但两组之间在第 2 年时无显著差异。用改良 Sharp 评分量化的影像学关节损伤在 OW 组中明显进展,而 TW 组中未见进展。因此,在接受 TW 治疗的患者中,关节损伤的进展可能已被抑制或已出现缓解。
这些结果表明,就 DAS-28 缓解而言,OW 治疗可有效地替代生物制剂初治 RA 患者的 TW 治疗。然而,TW 治疗在预防关节损伤恶化方面是不可或缺的。