Miwa Yusuke, Isojima Sakiko, Saito Mayu, Ikari Yuzo, Kobuna Mika, Hayashi Tomoki, Takahashi Ryo, Kasama Tsuyoshi, Hosaka Michio, Sanada Kenji
Division of Rheumatology, Department of Medicine, Showa University School of Medicine, Japan.
Intern Med. 2016;55(18):2581-5. doi: 10.2169/internalmedicine.55.6872. Epub 2016 Sep 15.
Objective We examined whether infliximab (IFX) therapy was more effective than methotrexate (MTX) monotherapy to achieve an improvement in depressive states in Rheumatoid Arthritis (RA) patients. Methods We examined 152 RA patients (72 IFX patients and 80 MTX patients). We conducted an open-label cohort study to evaluate the disease activity of RA (Simplified Disease Activity Index; SDAI), depressive states (Hamilton Rating Scale for Depression; HAM-D), Activity of Daily Living (ADL) (modified Health Assessment Questionnaire; mHAQ) and Quality of Life (QOL) [Short Form (SF)-36] in patients before and 6 months after receiving therapy. The HAM-D, SDAI, mHAQ and SF-36 scores after 6 months of therapy were measured as the outcomes. Results We analyzed 60 IFX patients and 53 MTX patients. The HAM-D scores significantly improved in both groups (p<0.001), but there was no significant difference in the effectiveness between the IFX and MTX therapies (p=0.792). The SDAI scores significantly improved in both groups after therapy (p<0.001), and IFX therapy was more effective than MTX therapy (p=0.004). The mHAQ and HAM-D scores also improved significantly in both groups after therapy (p<0.001), but no significant difference in the effectiveness between the IFX and MTX therapies was observed (p=0.272, 0.792). The scores of all 8 items of the SF-36 improved in both groups after therapy, but IFX therapy was more effective than MTX therapy in only 4 of the 8 items (p<0.05). Conclusion Both IFX and MTX therapy improved the clinical efficacy, ADL, QOL and depressive states. However, no significant differences regarding an improvement in the depressive states and ADL were observed between IFX therapy and MTX monotherapy.
目的 我们研究了英夫利昔单抗（IFX）治疗在改善类风湿关节炎（RA）患者抑郁状态方面是否比甲氨蝶呤（MTX）单药治疗更有效。方法 我们研究了152例RA患者（72例IFX治疗患者和80例MTX治疗患者）。我们进行了一项开放标签队列研究，以评估患者在接受治疗前和治疗6个月后的类风湿关节炎疾病活动度（简化疾病活动指数；SDAI）、抑郁状态（汉密尔顿抑郁评定量表；HAM-D）、日常生活活动能力（ADL）（改良健康评估问卷；mHAQ）和生活质量（QOL）[简短形式（SF）-36]。将治疗6个月后的HAM-D、SDAI、mHAQ和SF-36评分作为结果进行测量。结果 我们分析了60例IFX治疗患者和53例MTX治疗患者。两组的HAM-D评分均显著改善（p<0.001），但IFX治疗和MTX治疗在有效性方面无显著差异（p=0.792）。治疗后两组的SDAI评分均显著改善（p<0.001），且IFX治疗比MTX治疗更有效（p=0.004）。治疗后两组的mHAQ和HAM-D评分也显著改善（p<0.001），但未观察到IFX治疗和MTX治疗在有效性方面有显著差异（p=0.272，0.792）。治疗后两组SF-36的所有8项评分均有所改善，但IFX治疗仅在8项中的4项比MTX治疗更有效（p<0.05）。结论 IFX和MTX治疗均改善了临床疗效、ADL、QOL和抑郁状态。然而，在IFX治疗和MTX单药治疗之间，未观察到在改善抑郁状态和ADL方面有显著差异。
