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类风湿关节炎皮下注射抗 TNF 治疗的一线选择:一项前瞻性队列研究。

FIRST LINE OF SUBCUTANEOUS ANTI-TNF THERAPY FOR RHEUMATOID ARTHRITIS: A PROSPECTIVE COHORT STUDY.

机构信息

Health Assessment, Technology, and Economy Group, Center for Exact, Natural and Health Sciences, Federal University of Espírito Santo , Alegre, Brazil.

Department of Social Pharmacy, College of Pharmacy, Federal University of Minas Gerais , President Antônio Carlos Avenue, 6627, Campus Pampulha, Belo Horizonte, Brazil.

出版信息

Expert Rev Clin Immunol. 2020 Dec;16(12):1217-1225. doi: 10.1080/1744666X.2021.1850271. Epub 2020 Dec 15.

Abstract

: This study aims to evaluate and compare the use of subcutaneous anti-TNF for RA in a Brazilian real-life setting. : A prospective cohort of biological disease-modifying antirheumatic drug (bDMARD)-naïve patients treated with adalimumab, etanercept, golimumab, and certolizumab was developed. Medication persistence, disease activity by the Clinical Disease Activity Index (CDAI), functionality by the Health Assessment Questionnaire (HAQ), quality of life by the European Quality of Life 5 Dimensions (EQ-5D), and safety were evaluated at 6 and 12 months. : In a total of 327 individuals, 211 (64.5%) were persistent at 12 months. Patients improved after the use of anti-TNF, with a reduction in the mean of CDAI and HAQ, in addition to an increase in the mean of EQ-5D ( < 0.05). The number of patients who achieved the clinical response was 114 (34.86%) by CDAI, 212 (64.83%) by HAQ, and 215 (65.75%) by EQ-5D at 12 months. There were no statistically significant differences among the drugs ( > 0.05). The anti-TNF was well tolerated. : Anti-TNF reduced disease activity, in addition to improving patients' functionality and quality of life. Additional pharmacotherapeutic monitoring can be essential to achieve better results.

摘要

: 本研究旨在评估和比较巴西真实环境中 RA 患者皮下使用抗 TNF 的情况。: 建立了一个前瞻性队列,纳入了接受阿达木单抗、依那西普、戈利木单抗和赛妥珠单抗治疗的初治生物改善病情抗风湿药(bDMARD)患者。在 6 个月和 12 个月时,评估了药物的持续性、疾病活动度(临床疾病活动指数(CDAI))、功能(健康评估问卷(HAQ))、生活质量(欧洲五维健康量表(EQ-5D))和安全性。: 在总共 327 名患者中,有 211 名(64.5%)在 12 个月时仍在继续使用药物。患者在使用抗 TNF 后得到了改善,CDAI 和 HAQ 的平均值降低,EQ-5D 的平均值升高(<0.05)。在 12 个月时,有 114 名患者(34.86%)通过 CDAI、212 名患者(64.83%)通过 HAQ 和 215 名患者(65.75%)达到了临床应答。这些药物之间没有统计学上的显著差异(>0.05)。抗 TNF 药物耐受性良好。: 抗 TNF 不仅能降低疾病活动度,还能改善患者的功能和生活质量。进行额外的药物治疗监测可能对获得更好的结果至关重要。

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