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疾病持续时间和抗瓜氨酸化肽抗体状态与阿巴西普在生物初治类风湿关节炎患者中的疗效的相关性:日本多中心真实世界观察性研究的事后分析(ORIGAMI)。

Associations of disease duration and anti-citrullinated peptide antibody status with the effectiveness of abatacept in biologic-naïve patients with rheumatoid arthritis: Post hoc analysis of a multicentre, real-world observational study in Japan (ORIGAMI).

机构信息

Department of Rheumatology, Kita-Harima Medical Center, Hyogo, Japan.

Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan.

出版信息

Mod Rheumatol. 2024 Feb 26;34(2):297-306. doi: 10.1093/mr/road045.

Abstract

OBJECTIVES

The aim of the article is to investigate the associations of disease duration and anti-cyclic citrullinated peptide antibody (ACPA) status with the effectiveness of abatacept in biologic-naïve patients with rheumatoid arthritis (RA).

METHODS

We performed post hoc analyses of the Orencia® Registry in Geographically Assembled Multicenter Investigation (ORIGAMI) study of biologic-naïve RA patients aged ≥20 years with moderate disease activity who were prescribed abatacept. Changes in the Simplified Disease Activity Index (SDAI) and Japanese Health Assessment Questionnaire (J-HAQ) at 4, 24, and 52 weeks of treatment were analysed in patients divided according to ACPA serostatus (positive/negative), disease duration (<1/≥1 year), or both.

RESULTS

SDAI scores decreased from baseline in all groups. SDAI scores tended to decrease more in the ACPA-positive group and disease duration <1-year group than in the ACPA-negative group and disease duration ≥1-year group, respectively. In the disease duration <1-year group, SDAI tended to decrease more in the ACPA-positive group than in the ACPA-negative group. Disease duration was independently associated with the change in SDAI and SDAI remission at Week 52 in multivariable regression models.

CONCLUSIONS

These results suggest that starting abatacept within 1 year of diagnosis was associated with greater effectiveness of abatacept in biologic-naïve patients with RA and moderate disease activity.

摘要

目的

本文旨在探讨疾病持续时间和抗环瓜氨酸肽抗体(ACPA)状态与生物初治类风湿关节炎(RA)患者接受阿巴西普疗效的相关性。

方法

我们对生物初治 RA 患者的 ORIGAMI 研究中的 ORIGAMI 登记处进行了事后分析,这些患者年龄≥20 岁,疾病活动度中度,接受了阿巴西普治疗。根据 ACPA 血清学状态(阳性/阴性)、疾病持续时间(<1/≥1 年)或两者的不同,分析了治疗第 4、24 和 52 周时简化疾病活动指数(SDAI)和日本健康评估问卷(J-HAQ)的变化。

结果

所有组的 SDAI 评分均从基线下降。与 ACPA 阴性组和疾病持续时间≥1 年组相比,ACPA 阳性组和疾病持续时间<1 年组的 SDAI 评分下降趋势更明显。在疾病持续时间<1 年的组中,ACPA 阳性组的 SDAI 评分下降趋势更为明显。在多变量回归模型中,疾病持续时间与 SDAI 的变化和第 52 周时 SDAI 缓解相关。

结论

这些结果表明,在诊断后 1 年内开始使用阿巴西普与生物初治 RA 且疾病活动度中度的患者中阿巴西普的疗效更好相关。

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