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依那西普生物类似药用于治疗强直性脊柱炎髋关节关节炎患者的剂量减少的临床和 MRI 反应:一项观察性、回顾性队列研究。

Clinical and MRI response to dose reduction of an etanercept-biosimilar for hip arthritis in patients with ankylosing spondylitis: an observational, retrospective cohort study.

机构信息

Department of Rheumatology and Immunology, Guangdong Second Provincial General Hospital, No. 466 Xingangzhong Road, Guangzhou, 510317, China.

Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China.

出版信息

Clin Rheumatol. 2019 Jun;38(6):1595-1604. doi: 10.1007/s10067-019-04466-9. Epub 2019 Feb 12.

Abstract

OBJECTIVES

Hip arthritis plays a critical role in the prognosis of ankylosing spondylitis (AS). Dose reduction of tumor necrosis factor inhibitors preserves general improvement of AS, so this study attempted to examine the equivalence between Yisaipu® tapering and conventional therapy for hip arthritis in AS patients, using clinical parameters and magnetic resonance image (MRI).

METHODS

AS patients received this etanercept-biosimilar injections (50 mg/week) in the first 12 weeks. Participants in the tapering group were treated with this reagent 50 mg every other week from week 13 to week 24, while the control group kept undergoing full-dose therapy. Clinical and laboratory parameters were assessed at baseline, week 12 and week 24. MRI examination of hip was performed at baseline and week 24.

RESULTS

One hundred and thirty-six patients were enrolled, and 80 of them were in the tapering group. Linear mixed model revealed that main effects of tapering group with control group as reference in disease activity parameters were insignificant (p > 0.05). Main effects of baseline with week 24 as reference were significant (p < 0.05), but main effects of week 12 with week 24 as reference were not (p > 0.05). Prevalence of acute inflammatory change in MRI significantly decreased in the tapering group (76.88% vs 20.00%, p < 0.05) and control group (76.79% vs 19.64%, p < 0.05). Influence of both treatments on acute inflammatory change was equivalent (p > 0.05).

CONCLUSION

Efficacy of Yisaipu® tapering treatment is comparable to the full-dose therapy for hip arthritis in AS patients. Both treatments maintain remission of hip arthritis after patients achieved low disease activity.

摘要

目的

髋关节关节炎在强直性脊柱炎(AS)的预后中起着关键作用。减少肿瘤坏死因子抑制剂的剂量可以保持 AS 的整体改善,因此本研究试图通过临床参数和磁共振成像(MRI)来检查 Yisaipu®减量与 AS 患者髋关节关节炎的常规治疗之间的等效性。

方法

AS 患者在前 12 周内接受这种依那西普生物类似物注射(每周 50mg)。在第 13 周到第 24 周,减量组的患者每两周接受一次 50mg 治疗,而对照组则继续进行全剂量治疗。在基线、第 12 周和第 24 周评估临床和实验室参数。在基线和第 24 周进行髋关节 MRI 检查。

结果

共纳入 136 例患者,其中 80 例进入减量组。线性混合模型显示,与对照组相比,减量组在疾病活动参数方面的主要影响不显著(p>0.05)。基线与第 24 周的主要影响显著(p<0.05),但第 12 周与第 24 周的主要影响不显著(p>0.05)。MRI 中急性炎症变化的发生率在减量组(76.88%比 20.00%,p<0.05)和对照组(76.79%比 19.64%,p<0.05)中显著降低。两种治疗方法对急性炎症变化的影响相当(p>0.05)。

结论

Yisaipu®减量治疗与 AS 患者髋关节关节炎的全剂量治疗疗效相当。两种治疗方法都能在患者达到低疾病活动度后维持髋关节关节炎的缓解。

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