Nasonova Research Institute of Rheumatology, Moscow, Russia.
Mechnikov Northwestern State Medical University, Ministry of Health of the Russian Federation, St. Petersburg, Russia.
Dokl Biochem Biophys. 2023 Aug;511(1):180-186. doi: 10.1134/S1607672923700308. Epub 2023 Oct 13.
The aim of the study was to evaluate the effectiveness of UPA in RA patients in real clinical practice after 3 and 6 months of therapy. The study included 63 RA patients with high activity of the disease. Activity was assessed according to the DAS28(ESR), DAS28(CRP), SDAI, CDAI; functional ability to HAQ; quality of life to the EQ-5D; disease activity according to the patient's RAPID-3 index; the level of depression and anxiety to the HADS scale. The effectiveness of therapy was evaluated after 3 (n = 45) and 6 (n = 31) months of UPA therapy. Remission or low activity of the disease by 3 months of therapy was achieved by most patients: remission of 69.8% of patients, low activity of the disease-16.3% of patients. Moderate or high activity persisted in 13.9% of patients. By the 6th month of UPA therapy, the number of remissions reached 90%, low activity 3.3%, moderate activity persisted in 6.7% of patients, high activity of the disease was not in any patient. 20% improvement in function was achieved in 71.8% of patients by the 3rd month of therapy and in 77.8% by the 6th month of treatment; the difference in average HAQ values by the 3rd month of therapy was 0.38 points, by the 6th month-0.58 points. After 3 months of follow-up, 31.1% of patients continued taking GC, by 6 months-24.2%. The dose of GC was reduced from an average of 7.23 to 5.6 mg/s. The percentage of patients requiring NSAIDs decreased from 95.2 to 35.6% and 33.3%, respectively. DMARDs continued to be received by 75.6% of patients by 3 months and 69.7% by 6 months of follow-up. Achieving remission or low activity of the disease in patients with RA receiving UPA in real clinical practice is possible in most patients. A rapid decrease in inflammatory activity is accompanied by a significant improvement in the functional state and quality of life of patients. UPA therapy reduces the need for the use of NSAIDs and reduces the dose of GC in a third of patients.
本研究旨在评估 UPA 在真实临床实践中治疗 RA 患者 3 和 6 个月后的疗效。该研究纳入了 63 例疾病活动度较高的 RA 患者。根据 DAS28(ESR)、DAS28(CRP)、SDAI、CDAI 评估疾病活动度；用 HAQ 评估患者的功能能力；用 EQ-5D 评估生活质量；根据患者的 RAPID-3 指数评估疾病活动度；用 HADS 量表评估抑郁和焦虑程度。在接受 UPA 治疗 3（n = 45）和 6（n = 31）个月后评估治疗效果。大多数患者在 3 个月的治疗后达到疾病缓解或低活动度：缓解率为 69.8%，疾病低活动度率为 16.3%。13.9%的患者仍处于中度或高度活动度。在 UPA 治疗 6 个月时，缓解率达到 90%，疾病低活动度率为 3.3%，中度活动度持续率为 6.7%，没有患者处于高度活动度。在治疗第 3 个月，71.8%的患者实现了功能 20%的改善，在治疗第 6 个月，这一比例达到了 77.8%；治疗第 3 个月平均 HAQ 值降低了 0.38 分，第 6 个月降低了 0.58 分。在 3 个月的随访后，有 31.1%的患者继续服用 GC，到 6 个月时则有 24.2%的患者继续服用。GC 的剂量从平均 7.23mg 降至 5.6mg/s。需要 NSAIDs 的患者比例从 95.2%降至 35.6%和 33.3%，分别。在第 3 个月和第 6 个月的随访中，分别有 75.6%和 69.7%的患者继续接受 DMARDs 治疗。在接受 UPA 治疗的 RA 患者中，大多数患者可实现缓解或低疾病活动度。炎症活动度的快速下降伴随着患者功能状态和生活质量的显著改善。UPA 治疗减少了 NSAIDs 的使用需求，并使三分之一的患者 GC 剂量降低。
