Ogawa Noriyoshi, Ohashi Hiroyuki, Ota Yasuhiro, Kobori Kaori, Suzuki Motohiro, Tsuboi Seiji, Hayakawa Masakatsu, Goto Yoshinori, Karahashi Taro, Kimoto Osamu, Miyamoto Toshiaki, Furukawa Shogo, Shimoyama Kumiko, Suzuki Daisuke, Maekawa Yuichiro
a Division of Immunology and Rheumatology, Department of Internal Medicine 3 , Hamamatsu University School of Medicine , Hamamatsu-City , Japan.
b Department of Rheumatology, Omaezaki Municipal Hospital , Omaezaki-City , Japan.
Immunol Med. 2019 Mar;42(1):29-38. doi: 10.1080/25785826.2019.1605036. Epub 2019 May 8.
The aim of this study was to assess abatacept in rheumatoid arthritis (RA) patient. Patients (20 men, 89 women, aged 61.9 ± 10.4 y) who responded inadequately to conventional synthetic disease-modifying anti-rheumatic drug were treated with abatacept for 24-months. Disease activity score in 28 joints (DAS28-CRP) was evaluated. Of 109 patients, 82 (75.2%) were on methotrexate (MTX; mean dosage 9.0 ± 2.7 mg/week); 48 (44.0%) were naive to biologics and 61 (56.0%) had failed biologics. The 1- and 2-year retention rates were 77% and 53%, respectively. At 24-months, the DAS28-CRP remission rates were 54.5% in the biologic-naïve patients, and 28.2% in the biologic-failure patients ( < .01), while the structural remission rates were 83.9% and 73.1%, respectively ( = .461). Abatacept was equally effective in RA patients who were and were not on concomitant MTX. Biologic-naïve was associated with better clinical outcome. Abatacept was effective in patients who showed decreasing anti-CCP antibody titers or serum MMP-3 levels during treatment. Infection was the most frequent adverse effect of abatacept therapy. In conclusion, abatacept is more effective in biologic-naïve than in biologic-failure RA patients with or without concomitant use of MTX. Abatacept is more effective in RA patients with than without decreasing serum MMP-3 or anti-CCP antibody titers during treatment.
本研究旨在评估阿巴西普在类风湿关节炎（RA）患者中的疗效。对传统合成抗风湿药物反应欠佳的患者（20名男性，89名女性，年龄61.9±10.4岁）接受阿巴西普治疗24个月。评估28个关节的疾病活动评分（DAS28-CRP）。109例患者中，82例（75.2%）正在使用甲氨蝶呤（MTX；平均剂量9.0±2.7mg/周）；48例（44.0%）未使用过生物制剂，61例（56.0%）使用生物制剂失败。1年和2年的保留率分别为77%和53%。在24个月时，未使用过生物制剂的患者中DAS28-CRP缓解率为54.5%，使用生物制剂失败的患者中为28.2%（P<0.01），而结构缓解率分别为83.9%和73.1%（P=0.461）。阿巴西普在同时使用MTX和未使用MTX的RA患者中疗效相当。未使用过生物制剂与更好的临床结局相关。阿巴西普对治疗期间抗CCP抗体滴度或血清MMP-3水平降低的患者有效。感染是阿巴西普治疗最常见的不良反应。总之，对于未使用过生物制剂的RA患者，无论是否同时使用MTX，阿巴西普都比使用生物制剂失败的患者更有效。对于治疗期间血清MMP-3或抗CCP抗体滴度降低的RA患者，阿巴西普比未降低的患者更有效。
