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维生素D在类风湿关节炎患者联合治疗中的作用

The Role of Vitamin D in Combination Treatment for Patients With Rheumatoid Arthritis.

作者信息

Wu Jianhong, Dong Jianling, Li Shilin, Luo Jiaang, Zhang Yu, Liu Hong, Ni Yuanpiao, Li Xue, Zhou Jun, Yang Hang, Xie Qianrong, Jiang Xuejun, Wang Tingting, Wang Pingxi, Zeng Fanwei, Chu Yanpeng, Yang Jing, Zeng Fanxin

机构信息

Department of Rheumatology, Dazhou Central Hospital, Dazhou, China.

Department of Rheumatology, Mianyang Central Hospital, Mianyang, China.

出版信息

Front Med (Lausanne). 2020 Jul 15;7:312. doi: 10.3389/fmed.2020.00312. eCollection 2020.

DOI:10.3389/fmed.2020.00312
PMID:32766259
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7381115/
Abstract

The aim of this study is to evaluate the clinical efficacy of vitamin D (VitD) supplementation in terms of response to treatment and improvement of disease activity in rheumatoid arthritis (RA). This study analyzed 1180 RA patients' records treated at Mianyang Central Hospital from February 2015 to July 2019. The patients were allocated into VitD group and control group based on their medical regimens. The outcome measures were primary efficacy, defined as treatment response-based EULAR response criteria in RA, and secondary efficacy, defined as improvement in disease activity indicators. Safety was evaluated according to the incidence of all-cause infections. At month 6, the primary efficacy revealed that there were 22.8% good responders and 19.0% moderate responders in the VitD group, and 22.3% good responders and 22.3% moderate responders in the control group; there were no differences between the two groups ( = 0.754). The similar primary efficacy outcomes were observed at months 3, 12, and >12. The secondary efficacy indicated that there were no differences in most indexes between the two groups at months 1, 3, 6, 12, and >12. The subgroups (based on baseline DAS28 (CRP), glucocorticoids use and disease duration) analysis results suggested that VitD group didn't have the advantage for treating RA. The incidence of infections was similar in the two groups. VitD supplementation did not provide additional benefit for anti-rheumatic treatment. These data supported the need for prospective, randomized, controlled trials to evaluate the role of VitD supplementation in treating RA.

摘要

本研究旨在评估补充维生素D(VitD)在类风湿关节炎(RA)治疗反应和疾病活动改善方面的临床疗效。本研究分析了2015年2月至2019年7月在绵阳市中心医院接受治疗的1180例RA患者的记录。根据治疗方案将患者分为VitD组和对照组。疗效指标包括主要疗效,定义为基于RA治疗反应的欧洲抗风湿病联盟(EULAR)反应标准,以及次要疗效,定义为疾病活动指标的改善。根据全因感染发生率评估安全性。在第6个月时,主要疗效显示VitD组有22.8%的良好反应者和19.0%的中度反应者,对照组有22.3%的良好反应者和22.3%的中度反应者;两组之间无差异(P = 0.754)。在第3、12和>12个月时观察到类似的主要疗效结果。次要疗效表明,在第1、3、6、12和>12个月时,两组在大多数指标上无差异。亚组(基于基线疾病活动评分28(CRP)、糖皮质激素使用情况和病程)分析结果表明,VitD组在治疗RA方面没有优势。两组感染发生率相似。补充VitD并未为抗风湿治疗带来额外益处。这些数据支持需要进行前瞻性、随机、对照试验来评估补充VitD在治疗RA中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dd7/7381115/b9cddfe1ead4/fmed-07-00312-g0005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dd7/7381115/830bce751aba/fmed-07-00312-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dd7/7381115/3eed81dc1995/fmed-07-00312-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dd7/7381115/2089ff85ba9a/fmed-07-00312-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dd7/7381115/ba05ea2803ec/fmed-07-00312-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dd7/7381115/b9cddfe1ead4/fmed-07-00312-g0005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dd7/7381115/830bce751aba/fmed-07-00312-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dd7/7381115/3eed81dc1995/fmed-07-00312-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dd7/7381115/2089ff85ba9a/fmed-07-00312-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dd7/7381115/ba05ea2803ec/fmed-07-00312-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dd7/7381115/b9cddfe1ead4/fmed-07-00312-g0005.jpg

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Vitamin D as a Principal Factor in Mediating Rheumatoid Arthritis-Derived Immune Response.
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