Shu P, Shao S-Q, Cai X-N, Zhou D-M, Ma H, Lu L, Yin H-Q, Yin S-L
The Graduate School, Xuzhou Medical University, Xuzhou, Jiangsu, P.R. China.
Eur Rev Med Pharmacol Sci. 2021 Jul;25(14):4687-4692. doi: 10.26355/eurrev_202107_26379.
Iguratimod is a new kind of synthetic small molecule disease modified anti-rheumatic drug with good efficacy for rheumatoid arthritis (RA) treatment; meanwhile, it exhibits potency to alleviate alveolar inflammation and pulmonary fibrosis. However, its application in RA interstitial lung disease (ILD) patients is seldomly reported. Thus, the current study aimed to investigate the efficacy and safety of iguratimod plus glucocorticoid/cyclophosphamide vs. glucocorticoid/cyclophosphamide in treating RA-ILD patients.
Totally 101 RA-ILD patients underwent glucocorticoid/cyclophosphamide (Control group: n=61) or iguratimod plus glucocorticoid/cyclophosphamide (Iguratimod group: n=40) treatment were analyzed. General inflammation, disease activity, serum disease marker levels, high resolution lung computed tomography (HRCT) score, lung function indexes were evaluated within 24-week (W) treatment.
No difference of baseline demographic or disease-related features was observed between Iguratimod group and Control group. Iguratimod group showed lower levels of CRP and ESR at W4, W12 and W24; as well as decreased DAS28 score, rheumatoid factor and anti-cyclic citrullinate peptide antibody levels at W12 and W24 compared to Control group. HRCT score showed no difference between Iguratimod group and Control group at any time points. As to lung function indexes, forced vital capacity percent predicted [FVC (% predicted)], carbon monoxide diffusion capacity percent predicted [DLCO (%predicted)] and 6-minute-walk distance (6MWD) were all higher in Iguratimod group compared with Control group at W4, W12 and W24. Besides, no difference in adverse events was discovered between these two groups.
Iguratimod attenuates general inflammation, disease activity, and improves lung function in RA-ILD patients.
艾拉莫德是一种新型合成小分子疾病修正抗风湿药物，对类风湿关节炎（RA）治疗效果良好；同时，它还具有减轻肺泡炎症和肺纤维化的作用。然而，其在RA间质性肺疾病（ILD）患者中的应用鲜有报道。因此，本研究旨在探讨艾拉莫德联合糖皮质激素/环磷酰胺与糖皮质激素/环磷酰胺治疗RA-ILD患者的疗效和安全性。
对101例接受糖皮质激素/环磷酰胺治疗（对照组：n=61）或艾拉莫德联合糖皮质激素/环磷酰胺治疗（艾拉莫德组：n=40）的RA-ILD患者进行分析。在24周治疗期间评估全身炎症、疾病活动度、血清疾病标志物水平、高分辨率肺部计算机断层扫描（HRCT）评分、肺功能指标。
艾拉莫德组和对照组在基线人口统计学或疾病相关特征方面未观察到差异。艾拉莫德组在第4周、第12周和第24周时CRP和ESR水平较低；与对照组相比，在第12周和第24周时DAS28评分、类风湿因子和抗环瓜氨酸肽抗体水平降低。在任何时间点，艾拉莫德组和对照组的HRCT评分均无差异。关于肺功能指标，在第4周、第12周和第24周时，艾拉莫德组的用力肺活量预测值百分比[FVC（%预测值）]、一氧化碳弥散量预测值百分比[DLCO（%预测值）]和6分钟步行距离（6MWD）均高于对照组。此外，两组之间不良事件无差异。
艾拉莫德可减轻RA-ILD患者的全身炎症和疾病活动度，并改善肺功能。
