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希腊真实世界中初治 TNF 抑制剂应答不佳的类风湿关节炎、银屑病关节炎和中轴型脊柱关节炎成年患者应用戈利木单抗的疗效:GO-BEYOND 前瞻性观察性研究。

Real-world effectiveness of golimumab in adult patients with rheumatoid arthritis, psoriatic arthritis, and axial spondyloarthritis and an inadequate response to initial TNFi therapy in Greece: the GO-BEYOND prospective, observational study.

机构信息

Rheumatology Department, Aghios Pavlos" General Hospital of Thessaloniki, Thessaloniki, Greece.

Private Practice, Serres, Greece.

出版信息

Rheumatol Int. 2023 Oct;43(10):1871-1883. doi: 10.1007/s00296-023-05376-5. Epub 2023 Jul 5.

Abstract

The impact of golimumab (GLM) on remission or low disease activity (LDA) was evaluated in patients with moderate-to-severe rheumatoid arthritis (RA), progressive psoriatic arthritis (PsA), or severe axial spondyloarthritis (axSpA), who failed previous treatment for their rheumatic disease with one initial tumor necrosis factor α inhibitor (TNFi). This is a multicenter, prospective, real-world observational 18-month study, conducted in Greece. The primary endpoint, assessed at 6 months, included the proportion of patients attaining LDA and/or remission (Disease Activity Score for 28 joints based on C-reactive protein [DAS28-CRP] ≤ 3.2), minimal disease activity (MDA; MDA criteria), and moderate disease activity (Bath Ankylosing Spondylitis Disease Activity Index [BASDAI] score 4-7), respectively. Other endpoints evaluated the persistence to GLM treatment and its impact on patients' work productivity (Work Productivity and Activity Impairment [WPAI] instrument) and quality of life (QoL; EuroQoL5 dimensions 3 levels [EQ-5D-3L] questionnaire). Descriptive statistics, the Wilcoxon signed-rank test, and Kaplan-Meier method were used for analyses. At 6 months, LDA was achieved by 46.4% of patients with RA, MDA by 57.1% of patients with PsA, and BASDAI 4-7 by 24.1% of patients with axSpA. For all study patients, persistence rates on GLM were high (85.1-93.7%) over 18 months; all WPAI domain scores and the EQ-5D-3L index score improved significantly (p < 0.001) from baseline to 18 months. GLM treatment was effective in patients with RA, PsA, or axSpA who had failed previous treatment with one TNFi and led to significant WPAI and QoL improvements. Persistence rates were high. Trial registration number and date of registration: As per the local regulations the study has been registered at the national registry for non-interventional studies https://www.dilon.sfee.gr/studiesp_d.php?meleti_id=MK8259-6995 .

摘要

在先前使用一种初始肿瘤坏死因子-α抑制剂(TNFi)治疗失败的中重度类风湿关节炎(RA)、进展性银屑病关节炎(PsA)或重度轴性脊柱关节炎(axSpA)患者中,评估了戈利木单抗(GLM)对缓解或低疾病活动度(LDA)的影响。这是一项在希腊进行的多中心、前瞻性、真实世界观察性 18 个月研究。主要终点为 6 个月时达到 LDA 和/或缓解(基于 C 反应蛋白的 28 关节疾病活动评分[DAS28-CRP]≤3.2)、微小疾病活动度(MDA;MDA 标准)和中度疾病活动度(Bath 强直性脊柱炎疾病活动指数[BASDAI]评分 4-7)的患者比例。其他终点评估了 GLM 治疗的持续性及其对患者工作生产力(工作生产效率和活动障碍[WPAI]工具)和生活质量(QoL;EuroQoL5 维度 3 水平[EQ-5D-3L]问卷)的影响。采用描述性统计、Wilcoxon 符号秩检验和 Kaplan-Meier 方法进行分析。在 6 个月时,RA 患者中达到 LDA 的比例为 46.4%,PsA 患者为 57.1%,axSpA 患者为 24.1%。对于所有研究患者,GLM 的 18 个月持续率均较高(85.1-93.7%);所有 WPAI 领域评分和 EQ-5D-3L 指数评分均从基线显著改善(p<0.001)至 18 个月。在先前使用一种 TNFi 治疗失败的 RA、PsA 或 axSpA 患者中,GLM 治疗有效,并且显著改善了 WPAI 和 QoL。持续率较高。试验注册号和注册日期:根据当地法规,该研究已在非干预性研究国家注册处进行注册,网址为 https://www.dilon.sfee.gr/studiesp_d.php?meleti_id=MK8259-6995

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