Denver Arthritis Clinic, 200 Spruce Street, Suite 100, Denver, CO, 80230, USA.
Rheumatology and Osteoporosis Specialists, 820 Jordan Street Suite 201, Shreveport, LA, 71101-4616, USA.
Drugs R D. 2018 Sep;18(3):211-219. doi: 10.1007/s40268-018-0240-1.
For patients with rheumatoid arthritis (RA) who do not respond or lose response to anti-tumor necrosis factor (TNF) biologics, switching to a different anti-TNF can be an effective means to manage symptoms and disease progression. This study examined the utilization and effectiveness of intravenous golimumab within a real-world population of patients with RA switching directly from infliximab, a potent anti-TNF.
Patient charts (n = 113) were collected from five US-based rheumatology practices. Patient demographics, treatment characteristics, infliximab and intravenous golimumab utilization data, and Clinical Disease Activity Index (CDAI), Patient Global Assessment (PtGA), Physician Global Assessment (PhGA), and Routine Assessment of Patient Index Data (RAPID3) scores were extracted from charts. The effectiveness of intravenous golimumab was assessed by comparing disease activity status pre- and post-initiation of intravenous golimumab therapy.
Significant decreases in patient disease activity were observed following treatment with intravenous golimumab. Mean CDAI and PhGA scores significantly decreased, and a significantly increased proportion of the population exhibited low disease activity or remission in the post intravenous golimumab period (p < 0.05). Limited changes were observed through the RAPID3 and PtGA.
Findings from this study indicate that intravenous golimumab is effective in managing RA in a population of patients switching directly from infliximab (mean last dose 7.4 mg/kg).
对于类风湿关节炎（RA）患者，如果对肿瘤坏死因子（TNF）生物制剂无反应或失去反应，改用不同的 TNF 抑制剂可能是控制症状和疾病进展的有效手段。本研究考察了在直接从英夫利昔单抗（一种强效 TNF 抑制剂）转换过来的 RA 患者真实世界人群中，静脉用戈利木单抗的应用情况和疗效。
从美国五家风湿病诊所收集患者病历（n=113）。从病历中提取患者人口统计学特征、治疗特征、英夫利昔单抗和静脉用戈利木单抗使用数据，以及临床疾病活动指数（CDAI）、患者总体评估（PtGA）、医生总体评估（PhGA）和简化疾病活动指标（RAPID3）评分。通过比较静脉用戈利木单抗治疗前后患者的疾病活动状态来评估静脉用戈利木单抗的疗效。
静脉用戈利木单抗治疗后，患者疾病活动显著降低。CDAI 和 PhGA 评分均值显著下降，且静脉用戈利木单抗治疗后疾病活动低或缓解的患者比例显著增加（p<0.05）。RAPID3 和 PtGA 评分观察到的变化有限。
本研究结果表明，在直接从英夫利昔单抗（末次剂量平均 7.4mg/kg）转换过来的 RA 患者人群中，静脉用戈利木单抗治疗有效。
