Department of Rheumatology & Immunology, The Affiliated Suqian First People's Hospital of Nanjing Medical University, Suqian, China.
Immun Inflamm Dis. 2024 Feb;12(2):e1166. doi: 10.1002/iid3.1166.
Adalimumab (ADA) and etanercept (ETN) are the most commonly applied biologics for rheumatoid arthritis (RA) management in China; however, the evidence regarding their superiority is controversial. In addition, in real-world clinical settings, many factors may affect the application of these agents, such as dosage and administration period. Therefore, the present real-world study aimed to compare the efficacy and safety of ADA and ETN treatment in RA patients via the propensity score matching method.
In total, 105 RA patients receiving ADA (n = 66) or ETN (n = 39) were reviewed in this retrospective study. The propensity score matching method was used to eliminate discrepancies in baseline features. Clinical response, low disease activity (LDA), and remission were evaluated based on the DAS28.
Before propensity score matching, compared with ETN, ADA yielded higher rates of clinical response at W24 (97.0% vs. 84.6%, p = .021), LDA at W12 (78.8% vs. 51.3%, p = .003), and remission at W24 (75.8% vs. 46.2%, p = .002). After propensity score matching, compared with ETN, ADA only achieved a higher rate of clinical response at W24 (96.3% vs. 77.8%, p = .043), whereas the rates of LDA and remission were not different between ADA and ETN treatments at any time point (all p > .05). In addition, the incidence of adverse events was not significantly different between the ADA and ETN treatments (all p > .05).
ADA shows superiority over ETN in terms of a numerically greater response rate and equivalent adverse events.
阿达木单抗（ADA）和依那西普（ETN）是中国治疗类风湿关节炎（RA）最常用的生物制剂；然而，关于它们优越性的证据存在争议。此外，在真实临床环境中，许多因素可能会影响这些药物的应用，例如剂量和给药周期。因此，本真实世界研究旨在通过倾向评分匹配方法比较 ADA 和 ETN 治疗 RA 患者的疗效和安全性。
本回顾性研究共纳入 105 例接受 ADA（n=66）或 ETN（n=39）治疗的 RA 患者。采用倾向评分匹配法消除基线特征差异。根据 DAS28 评估临床缓解、低疾病活动度（LDA）和缓解。
在进行倾向评分匹配前，与 ETN 相比，ADA 在第 24 周时临床缓解率更高（97.0% vs. 84.6%，p=0.021）、第 12 周时 LDA 更高（78.8% vs. 51.3%，p=0.003）、第 24 周时缓解率更高（75.8% vs. 46.2%，p=0.002）。在进行倾向评分匹配后，与 ETN 相比，ADA 仅在第 24 周时临床缓解率更高（96.3% vs. 77.8%，p=0.043），而在任何时间点 LDA 和缓解率在 ADA 和 ETN 治疗之间均无差异（均 p>0.05）。此外，ADA 和 ETN 治疗的不良反应发生率无显著差异（均 p>0.05）。
ADA 在应答率方面优于 ETN，且不良反应发生率相当。
