类风湿关节炎伊拉克患者早期或晚期使用依那西普治疗后的临床结果

Clinical Outcomes in Iraqi Patients with Rheumatoid Arthritis Following Earlier or Later Treatment with Etanercept.

作者信息

Al-Ani Nizar, Gorial Faiq, Yasiry Dina, Al Derwibee Fadya, Abbas Humadi Yasameen, Sunna Nancy, AlJabban Ali

机构信息

Rheumatology Unit, College of Medicine, University of Baghdad, Baghdad, Iraq.

Department of Rheumatology, Baghdad Teaching Hospital, Baghdad, Iraq.

出版信息

Open Access Rheumatol. 2021 Apr 19;13:57-62. doi: 10.2147/OARRR.S300838. eCollection 2021.

DOI:10.2147/OARRR.S300838

PMID:33907478

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8064720/

Abstract

PURPOSE

The development of evidence-based guidelines on early pharmacotherapeutic treatment of rheumatoid arthritis (RA) could be useful in Middle Eastern nations striving to improve outcomes in patients with this chronic, debilitating disease. Evidence obtained from local populations should inform such guidelines and therefore our aim was to use real-world data to evaluate the clinical responses of Iraqi patients with RA who received earlier or later treatment with the TNF inhibitor etanercept.

PATIENTS AND METHODS

Data from patients registered in the Iraq National Center of Rheumatology database from May 2012 to December 2018, inclusive, were analyzed retrospectively. Inclusion criteria were age ≥18 years, meeting the ACR/EULAR 2010 criteria for RA, referral for etanercept treatment, and ≥1 year of follow-up after etanercept initiation. Patients were excluded if they had received another biologic for RA. Included patients were categorized according to two separate stratifications: whether duration of RA symptoms prior to etanercept initiation was ≤10 or >10 years (10 years represented the mean duration for the entire analysis population); and according to whether duration of RA symptoms prior to etanercept initiation was ≤1, >1 to ≤4, >4 to ≤10, >10 to ≤20, or >20 years. The evaluated outcomes were mean change from baseline in Clinical Disease Activity Index (CDAI) and 28-joint Disease Activity Score (DAS28) after 1 year of etanercept treatment.

RESULTS

A total of 979 patients were included. CDAI and DAS28 were significantly reduced (p<0.001 for both) after 1 year of etanercept treatment irrespective of whether duration of RA symptoms prior to treatment was ≤10 or >10 years. Patients with RA symptoms for ≤1 year prior to etanercept initiation showed a significant reduction in CDAI after 1 year of treatment (p=0.01).

CONCLUSION

Iraqi patients with RA who received earlier treatment with etanercept had superior outcomes compared with those who received later treatment.

摘要

目的

制定基于证据的类风湿关节炎（RA）早期药物治疗指南，可能有助于中东国家改善这种慢性致残性疾病患者的治疗效果。从当地人群中获得的证据应为这类指南提供参考，因此我们的目的是利用真实世界数据评估接受肿瘤坏死因子抑制剂依那西普早期或晚期治疗的伊拉克RA患者的临床反应。

患者与方法

对2012年5月至2018年12月（含）在伊拉克国家风湿病中心数据库登记的患者数据进行回顾性分析。纳入标准为年龄≥18岁，符合2010年美国风湿病学会/欧洲抗风湿病联盟（ACR/EULAR）RA标准，因依那西普治疗而转诊，且依那西普开始治疗后随访≥1年。如果患者接受过另一种治疗RA的生物制剂，则将其排除。纳入的患者根据两种不同的分层进行分类：依那西普开始治疗前RA症状持续时间≤10年或>10年（10年为整个分析人群的平均持续时间）；以及依那西普开始治疗前RA症状持续时间≤1年、>1至≤4年、>4至≤10年、>10至≤20年或>20年。评估的结局指标为依那西普治疗1年后临床疾病活动指数（CDAI）和28关节疾病活动评分（DAS28）相对于基线的平均变化。