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双重过滤血浆置换联合生物制剂治疗活动期难治性类风湿关节炎的疗效与安全性:一项回顾性队列研究

Efficacy and safety of dual filtration plasmapheresis combined with biological agents in active refractory rheumatod arthritis: A retrospective cohort study.

作者信息

Xing Yida, Wang Shouquan, Liu Changyan, Wang Hongjiang, Zhao Mingli, Jin Bo, Kong Xiaodan

机构信息

Department of Rheumatology, the Second Affiliated Hospital of Dalian Medical University.

Department of Neurosurgery, Dalian Municipal Central Hospital of Dalian Medical University, Dalian, Liaoning.

出版信息

Medicine (Baltimore). 2020 Jul 10;99(28):e20966. doi: 10.1097/MD.0000000000020966.

Abstract

To investigate the effectiveness of dual filtration plasmapheresis (DFPP), a novel blood purification treatment, as a rapid and sustained disease-modifying therapy for active refractory rheumatoid arthritis (RA).A retrospective cohort study had been conducted. One hundred fifty three patients aged 18 years or older with active refractory RA were treated with DFPP combined with infliximab (IFX), IFX, or glucocorticoid (GC), all the above treatments were combined with methotrexate (MTX).Baseline characteristic of the 153 patients (DFPP: n = 53; IFX: n = 51; GC: n = 49) were similar across groups. The remission rate of CDAI (SDAI) in the DFPP treatment group was significantly higher than that of the IFX and GC group after 3 months of treatment. The remission rate of DFPP treatment group was above 50%, while in IFX and GC group, the rate of CDAI (SDAI) remission was 41.2% (37.3%) and 22.4% (14.2%) after 3 months of treatment.A combination of DFPP and biological agents can quickly induce remission or low disease activity of active refractory RA.

摘要

为研究双重过滤血浆置换术(DFPP)这一新型血液净化治疗方法作为活动性难治性类风湿关节炎(RA)的快速且持续的病情改善疗法的有效性。开展了一项回顾性队列研究。153例18岁及以上的活动性难治性RA患者接受了DFPP联合英夫利昔单抗(IFX)、IFX或糖皮质激素(GC)治疗,上述所有治疗均联合甲氨蝶呤(MTX)。153例患者(DFPP组:n = 53;IFX组:n = 51;GC组:n = 49)的基线特征在各组间相似。治疗3个月后,DFPP治疗组的临床疾病活动指数(CDAI)(简化疾病活动指数[SDAI])缓解率显著高于IFX组和GC组。DFPP治疗组的缓解率高于50%,而在IFX组和GC组,治疗3个月后CDAI(SDAI)缓解率分别为41.2%(37.3%)和22.4%(14.2%)。DFPP与生物制剂联合应用可迅速诱导活动性难治性RA缓解或达到低疾病活动度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed4c/7360202/0fe8ef5e511d/medi-99-e20966-g004.jpg

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