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生物制剂对糖尿病控制不佳的类风湿关节炎患者预后的影响。

Effects of biologic drugs on the prognosis of rheumatoid arthritis among patients with poor diabetes control.

作者信息

Miwa Yusuke, Mitamura Yuko

机构信息

Division of Rheumatology, Department of Medicine, Showa University, Tokyo, Japan.

Department of Nursing, Showa University, Tokyo, Japan.

出版信息

Eur J Rheumatol. 2020 Apr;7(2):60-63. doi: 10.5152/eurjrheum.2019.19144. Epub 2020 Jan 2.

Abstract

OBJECTIVE

To investigate the effects of biological disease-modifying antirheumatic drugs (bDMARDs) on diabetes control among patients with rheumatoid arthritis (RA).

METHODS

A total of 296 patients with RA were included in the study. The following background factors were investigated: age, gender, bDMARD type, methotrexate and prednisolone (PSL) dosages, glycated hemoglobin (HbA1c), C-reactive protein, and matrix metalloproteinase-3. We used the simplified disease activity index (SDAI) to evaluate the RA disease activity. Poor diabetes mellitus (DM) control was defined as a HbA1c of 6.0; accordingly, the patients were divided into good and poor DM control groups. SDAI and PSL dosage were the primary endpoints, respectively, 1 year later.

RESULTS

HbA1c ranged from 6.6±0.68 to 6.5±0.82 and 5.1±0.29 to 5.4±0.34 in the poor and good DM control groups, respectively. Although the intergroup difference was significant (p=0.000), there was no significant intergroup difference during the treatment period (p=0.084). The SDAI ranged from 27.7±15.6 to 7.1±8.0 in the group with a poor DM control (n=83) and from 22.9±14.0 to 6.3±7.6 in the group with a good DM control (n=213).

CONCLUSION

The bDMARD therapy reduced the RA disease activity regardless of a good or poor DM control.

摘要

目的

探讨生物性改善病情抗风湿药(bDMARDs)对类风湿关节炎(RA)患者糖尿病控制的影响。

方法

本研究共纳入296例RA患者。调查了以下背景因素:年龄、性别、bDMARD类型、甲氨蝶呤和泼尼松龙(PSL)剂量、糖化血红蛋白(HbA1c)、C反应蛋白和基质金属蛋白酶-3。我们使用简化疾病活动指数(SDAI)评估RA疾病活动度。糖尿病(DM)控制不佳定义为HbA1c≥6.0%;据此,将患者分为DM控制良好组和控制不佳组。分别将1年后的SDAI和PSL剂量作为主要终点指标。

结果

DM控制不佳组和控制良好组HbA1c分别为6.6±0.68%至6.5±0.82%和5.1±0.29%至5.4±0.34%不等。虽然组间差异有统计学意义(p=0.000),但治疗期间组间差异无统计学意义(p=0.084)。DM控制不佳组(n=83)的SDAI为27.7±15.6至7.1±8.0,DM控制良好组(n=213)为22.9±14.0至6.3±7.6。

结论

无论DM控制良好与否,bDMARD治疗均可降低RA疾病活动度。

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