Mahmood Naza Mohammed Ali, Hussain Saad Abdulrahman, Mirza Raouf Rahim
Department of Pharmacology and Toxicology, College of Pharmacy, University of Sulaimani, Kurdistan Region, Iraq.
Department of Pharmacology and Toxicology, Faculty of Pharmacy, Al-Rafidain University College, Baghdad, Iraq,
Ther Clin Risk Manag. 2018 Aug 7;14:1379-1385. doi: 10.2147/TCRM.S174693. eCollection 2018.
Much evidence has emerged documenting the involvement of the renin-angiotensin system (RAS) in inflammatory processes. The objective of this study was to evaluate the effects of blocking RAS with azilsartan (Azil) on the clinical efficacy of etanercept (Etan) in patients with active rheumatoid arthritis (RA).
Forty-two patients diagnosed with active RA and poorly responding to methotrexate were enrolled in this pilot clinical study. They were randomly allocated into two groups, and treated with either Etan (50 mg/week) and placebo or the same dose of Etan with Azil (20 mg/day) for 90 days. The clinical outcome was evaluated using the Disease Activity Score-28 joint (DAS-28), simplified disease activity index (SDAI), clinical disease activity index (CDAI) and the health assessment questionnaire disease index (HAQ-DI). Blood samples were obtained for the assessment of C-reactive protein and erythrocyte sedimentation rate at baseline and after 90 days.
The markers of pain and disease activity, C-reactive protein and erythrocyte sedimentation rate were significantly improved when Azil was used, as an adjuvant with Etan, compared with the use of Etan and placebo.
Blocking RAS with azilsartan may improve the effects of etanercept on the clinical markers of pain and disease severity of patients with active RA not responding to methotrexate.
已有大量证据证明肾素-血管紧张素系统（RAS）参与炎症过程。本研究的目的是评估用阿齐沙坦（Azil）阻断RAS对活性类风湿关节炎（RA）患者使用依那西普（Etan）的临床疗效的影响。
42例被诊断为活性RA且对甲氨蝶呤反应不佳的患者纳入了这项初步临床研究。他们被随机分为两组，分别接受Etan（50毫克/周）加安慰剂治疗或相同剂量的Etan加Azil（20毫克/天）治疗90天。使用28个关节疾病活动评分（DAS-28）、简化疾病活动指数（SDAI）、临床疾病活动指数（CDAI）和健康评估问卷疾病指数（HAQ-DI）评估临床结局。在基线和90天后采集血样以评估C反应蛋白和红细胞沉降率。
与使用Etan加安慰剂相比，当Azil与Etan联合使用时，疼痛和疾病活动的标志物C反应蛋白和红细胞沉降率显著改善。
用阿齐沙坦阻断RAS可能会改善依那西普对甲氨蝶呤反应不佳的活性RA患者疼痛和疾病严重程度临床标志物的影响。
