Svensson John, Holmqvist Marie, Tjärnlund Anna, Dastmalchi Maryam, Hanna Balsam, Magnusson Bucher Sara, Lundberg Ingrid E
Rheumatology unit, Department of Medicine Solna, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
Clin Exp Rheumatol. 2017 May-Jun;35(3):512-515. Epub 2016 Dec 9.
Biologic treatment has revolutionised treatment in rheumatology in the last decades. Patients with idiopathic inflammatory myopathies (IIM) have so far only been treated with biologics off-label, with little published follow-up on those who are treated and how they are treated. We therefore set out to characterise the Swedish IIM patients who have been treated with biologics.
By linking Swedish registers we identified 95 patients with IIM who were treated with biologics between 2000 and 2011. Via chart review the diagnoses were validated and clinical characteristics extracted.
In total, 95 individuals with IIM and biologic treatment were identified. Median disease duration was 5.5 years at start of biologics. All patients had been treated with prednisolone and failed at least one previous DMARD before the start of first biologic. Rituximab was the most common biologic drug, followed by anakinra and TNFinhibitors. Median overall treatment length was 10 months and varied between 5 and 12.5 months or the different therapies.
Off-label treatment of IIMs is often tried and seldom successful. This study shows a large unmet need for novel treatments and therapies in IIM. It is therefore important to follow these patients in a structured way to learn about effects and potential risks for different subgroups of IIM associated with different therapies.
在过去几十年中,生物治疗彻底改变了风湿病的治疗方式。迄今为止,特发性炎性肌病(IIM)患者仅接受了生物制剂的超说明书用药治疗,关于接受治疗的患者及其治疗方式的随访报道很少。因此,我们着手对接受生物制剂治疗的瑞典IIM患者进行特征描述。
通过关联瑞典的登记资料,我们确定了95例在2000年至2011年间接受生物制剂治疗的IIM患者。通过病历审查对诊断进行了验证,并提取了临床特征。
总共确定了95例接受生物制剂治疗的IIM患者。开始使用生物制剂时的疾病中位病程为5.5年。所有患者均接受过泼尼松龙治疗,并且在开始使用第一种生物制剂之前至少有一种先前的改善病情抗风湿药治疗失败。利妥昔单抗是最常用的生物制剂药物,其次是阿那白滞素和肿瘤坏死因子抑制剂。总体治疗的中位时长为10个月,不同疗法之间的时长在5至12.5个月之间。
IIM的超说明书用药治疗经常尝试但很少成功。这项研究表明IIM对新的治疗方法有很大的未满足需求。因此,以结构化方式随访这些患者以了解不同疗法对IIM不同亚组的疗效和潜在风险很重要。