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依那西普单药治疗对日本甲氨蝶呤初治的活动期类风湿关节炎患者的影像学和临床结局。

Radiographic and clinical outcomes following etanercept monotherapy in Japanese methotrexate-naïve patients with active rheumatoid arthritis.

机构信息

Division of Rheumatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan.

Department of Medicine and Rheumatology, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.

出版信息

Mod Rheumatol. 2020 Mar;30(2):259-268. doi: 10.1080/14397595.2019.1589918. Epub 2019 Mar 29.

Abstract

Compare outcomes with methotrexate (MTX) or etanercept (ETN) monotherapy in Japanese patients with active rheumatoid arthritis (RA) who were MTX-naïve or with intolerance or inadequate response to prior MTX (MTX-IR). analysis of a phase 3 study comparing MTX, ETN 10 mg twice weekly, and ETN 25 mg twice weekly in Japanese patients with RA. Disease activity was evaluated using American College of Rheumatology (ACR) scores and 28-joint Disease Activity Score (DAS28), radiographic progression evaluated using van der Heijde's modified Total Sharp Score (mTSS), and functional status evaluated using Health Assessment Questionnaire Disability Index (HAQ-DI). Among MTX-naïve and MTX-IR patients, greater proportions of those randomized to either ETN group achieved ACR20, ACR50, ACR70, DAS28 ≤3.2 or <2.6, clinically relevant inhibition of mTSS changes, and reductions in HAQ-DI compared with MTX at the majority of time points. There were very few clinically meaningful differences between ETN groups for any of the variables evaluated. ETN monotherapy was more effective than MTX in both MTX-naïve and MTX-IR patients, with very few clinically meaningful differences between ETN 10 mg and ETN 25 mg when given twice weekly. The relative benefits of ETN were greater in MTX-naïve patients than MTX-IR patients.NCT00445770.

摘要

比较在日本 MTX 初治或对 MTX 不耐受或反应不足的活动性类风湿关节炎(RA)患者中,与甲氨蝶呤(MTX)或依那西普(ETN)单药治疗相比,MTX 与 ETN 联合治疗的疗效。 这是一项比较 MTX、ETN 10mg 每周 2 次和 ETN 25mg 每周 2 次治疗日本 RA 患者的 3 期研究的分析。使用美国风湿病学会(ACR)评分和 28 关节疾病活动度评分(DAS28)评估疾病活动度,使用 van der Heijde 改良总 Sharp 评分(mTSS)评估放射学进展,使用健康评估问卷残疾指数(HAQ-DI)评估功能状态。在 MTX 初治和 MTX 反应不足的患者中,与 MTX 相比,更多随机分配到 ETN 组的患者在大多数时间点达到 ACR20、ACR50、ACR70、DAS28≤3.2 或<2.6、mTSS 变化的临床相关抑制和 HAQ-DI 降低。在评估的任何变量中,ETN 组之间很少有临床意义上的差异。ETN 单药治疗在 MTX 初治和 MTX 反应不足的患者中均比 MTX 更有效,每周 2 次给予 ETN 10mg 和 ETN 25mg 时,很少有临床意义上的差异。与 MTX 反应不足的患者相比,ETN 在 MTX 初治患者中的相对益处更大。NCT00445770。

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