Ogdie Alexis, Maksabedian Hernandez Ervant J, Shaw Yomei, Stolshek Bradley, Michaud Kaleb
Hospital of the University of Pennsylvania, Philadelphia.
Amgen Inc., Thousand Oaks, California.
ACR Open Rheumatol. 2022 Nov;4(11):935-941. doi: 10.1002/acr2.11467. Epub 2022 Aug 15.
To examine the prevalence of side effects with methotrexate (MTX) and tumor necrosis factor inhibitors (TNFi) among patients with psoriatic arthritis (PsA) and rheumatoid arthritis (RA).
This retrospective analysis, conducted between January 2000 and January 2019, used data from the FORWARD databank. Adult patients enrolled in the registry with self-reported and physician-confirmed diagnosis of PsA or RA were included if they had completed at least one questionnaire before initiating and within 12 months following initiation of MTX or a TNFi. The primary outcome was to examine the prevalence of side effects with MTX and TNFi within the year following treatment initiation. Multivariate logistic regression analysis was performed to examine the association between PsA and RA and the reporting of their side effects.
Overall, 116 patients with PsA and 4247 patients with RA newly initiated MTX, and 124 patients with PsA and 4361 patients with RA newly initiated a TNFi. Patients with PsA were more likely to report MTX-related side effects than those with RA (44.8% vs. 29.4%), whereas similar proportions of patients with PsA and RA reported TNFi-related side effects within the first year (24.2% and 22.8%, respectively). Additionally, patients with PsA initiating MTX were more likely to report nausea, vomiting, abdominal pain, depression, and tinnitus than patients with RA initiating MTX or those with PsA or RA initiating a TNFi.
Patients with PsA reported more side effects than patients with RA, and this difference was more pronounced in those receiving MTX versus TNFi.
研究甲氨蝶呤（MTX）和肿瘤坏死因子抑制剂（TNFi）在银屑病关节炎（PsA）和类风湿关节炎（RA）患者中的副作用发生率。
这项回顾性分析于2000年1月至2019年1月进行，使用了FORWARD数据库的数据。纳入登记册中自我报告并经医生确诊为PsA或RA的成年患者，前提是他们在开始使用MTX或TNFi之前以及开始使用后的12个月内至少完成了一份问卷。主要结局是检查治疗开始后一年内MTX和TNFi的副作用发生率。进行多变量逻辑回归分析以检查PsA和RA与其副作用报告之间的关联。
总体而言，116例PsA患者和4247例RA患者新开始使用MTX，124例PsA患者和4361例RA患者新开始使用TNFi。PsA患者比RA患者更有可能报告与MTX相关的副作用（44.8%对29.4%），而在第一年中，PsA和RA患者报告与TNFi相关副作用的比例相似（分别为24.2%和22.8%）。此外，开始使用MTX的PsA患者比开始使用MTX的RA患者或开始使用TNFi的PsA或RA患者更有可能报告恶心、呕吐、腹痛、抑郁和耳鸣。
PsA患者报告的副作用比RA患者多，并且这种差异在接受MTX的患者中比接受TNFi的患者中更为明显。
