Department of Rheumatology, Niigata Rheumatic Center, Japan.
Department of Orthopedic Surgery, Yamanashi Red Cross Hospital, Japan.
Intern Med. 2021 May 1;60(9):1359-1367. doi: 10.2169/internalmedicine.5381-20. Epub 2020 Nov 30.
Objective To evaluate the effectiveness and drug retention rate of golimumab (GLM) for long-term use in daily practice for patients with rheumatoid arthritis (RA). Methods Patients with RA who started GLM therapy with a minimum follow-up period of 52 weeks were included. The patients were divided into a biologic-naïve group and switch group. The disease activity score (DAS) 28-erythrocyte sedimentation rate (ESR) (DAS28-ESR), grip power, and Japanese version of the health assessment questionnaire (J-HAQ) score were assessed. In addition, the treatment continuation rate was evaluated at the final follow-up. Patients Sixty-five patients [58 women and 7 men; median (range) age, 69 (61-74) years; median (range) disease duration, 9 (5-16) years] were included. Twenty-eight patients were biologic-naïve (naïve group), and 37 were switched to biologics (switch group). Results The median (range) follow-up period was 134 (58-162) weeks. The DAS28-ESR improved from a median (range) of 4.31 (3.52-5.25) to 2.65 (2.28-3.77) in the naïve group and from 4.27 (3.19-4.89) to 2.89 (2.49-3.88) in the switch group. The grip power improved in both groups (p<0.01); however, the J-HAQ score showed no marked improvement in either group. The continuation rates were 22/28 (78.6%) in the naïve group, and 26/37 (70.3%) in the switch group at the final follow-up. Conclusion We herein report for the first time that the long-term use of GLM improves the grip power. Improving the grip power may help prevent sarcopenia and frailty in the future. Given the efficacy and high continuation rate, we suggest that GLM would be a well-tolerated treatment option for RA.
评估在日常实践中,对于类风湿关节炎(RA)患者,长期使用戈利木单抗(GLM)的有效性和药物保留率。
纳入至少随访 52 周开始 GLM 治疗的 RA 患者。患者分为生物制剂初治组和转换组。评估疾病活动评分(DAS)28-红细胞沉降率(ESR)(DAS28-ESR)、握力和日本版健康评估问卷(J-HAQ)评分。此外,在最后一次随访时评估治疗的持续率。
共纳入 65 例患者[58 名女性和 7 名男性;中位(范围)年龄 69(61-74)岁;中位(范围)病程 9(5-16)年]。28 例患者为生物制剂初治(初治组),37 例患者转换为生物制剂(转换组)。
中位(范围)随访时间为 134(58-162)周。DAS28-ESR 自初治组的中位数(范围)4.31(3.52-5.25)改善至 2.65(2.28-3.77),转换组自中位数(范围)4.27(3.19-4.89)改善至 2.89(2.49-3.88)。两组握力均有改善(p<0.01);然而,两组的 J-HAQ 评分均无明显改善。初治组的持续率为 22/28(78.6%),转换组为 26/37(70.3%)。
我们首次报道,长期使用 GLM 可改善握力。改善握力可能有助于预防未来的肌肉减少症和虚弱。鉴于疗效和高持续率,我们建议 GLM 是治疗 RA 的一种耐受良好的治疗选择。