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肥胖可能不会改变类风湿关节炎患者托法替布的药物生存期。

Obesity might not alter tofacitinib drug survival in rheumatoid arthritis patients.

作者信息

Kayacan Erdoğan Esra, Armağan Berkan, Koçak Ulucaköy Rezan, Orhan Kevser, Can Güven Serdar, Özdemir Ulusoy Bahar, Konak Hatice Ecem, Karakaş Özlem, Akyüz Dağlı Pınar, Atalar Ebru, Doğan İsmail, Maraş Yüksel, Omma Ahmet, Küçükşahin Orhan, Erten Şükran, Babaoğlu Hakan

机构信息

Department of Internal Medicine, Division of Rheumatology, Ankara Bilkent City Hospital, Ankara, Turkey.

Department of Rheumatology, Ankara Gaziler Physical Therapy and Rehabilitation Training and Research Hospital, Ankara, Turkey.

出版信息

Wien Klin Wochenschr. 2025 Jan;137(1-2):49-55. doi: 10.1007/s00508-024-02424-3. Epub 2024 Sep 11.

Abstract

INTRODUCTION

Obese rheumatoid arthritis (RA) patients often show reduced responses to traditional treatments, including TNF inhibitors (TNFi). Considering the different mechanisms of action it is important to evaluate the efficacy of tofacitinib in obese patients. This study aims to explore the impact of obesity on the drug survival of tofacitinib in RA patients.

MATERIAL AND METHODS

This retrospective cohort study included RA patients treated with tofacitinib. Patients were categorized into obese (BMI ≥ 30 kg/m) and non-obese (BMI < 30 kg/m) groups. The primary outcome was drug survival, assessed using Kaplan-Meier and logistic regression analyses.

RESULTS

The study comprised 80 RA patients, with 31 (39%) classified as obese. At the 12-month mark, the drug survival rate for tofacitinib was higher in the obese group (81%) compared to the non-obese group (59%). Contrary to univariable analysis, multivariate analysis did not identify obesity as a significant predictor of drug survival. Other variables including sex, hypertension, diabetes mellitus, and anti-cyclic citrullinated peptide (anti-CCP) positivity also showed no significant association with tofacitinib drug survival.

CONCLUSION

The findings indicate that obesity does not alter the drug survival rate for tofacitinib among RA patients. Univariate analysis reported a potentially higher drug survival rate in obese patients; however, the lack of statistical significance in multivariate analysis and the study's retrospective nature necessitate further research to validate these observations and guide personalized therapeutic strategies for this population.

摘要

引言

肥胖的类风湿关节炎(RA)患者对包括肿瘤坏死因子抑制剂(TNFi)在内的传统治疗往往反应较差。考虑到不同的作用机制,评估托法替布在肥胖患者中的疗效很重要。本研究旨在探讨肥胖对RA患者中托法替布药物留存率的影响。

材料与方法

这项回顾性队列研究纳入了接受托法替布治疗的RA患者。患者被分为肥胖组(BMI≥30kg/m²)和非肥胖组(BMI<30kg/m²)。主要结局是药物留存率,采用Kaplan-Meier法和逻辑回归分析进行评估。

结果

该研究包括80例RA患者,其中31例(39%)被归类为肥胖。在12个月时,肥胖组托法替布的药物留存率(81%)高于非肥胖组(59%)。与单变量分析相反,多变量分析未将肥胖确定为药物留存率的显著预测因素。包括性别、高血压、糖尿病和抗环瓜氨酸肽(anti-CCP)阳性在内的其他变量也与托法替布的药物留存率无显著关联。

结论

研究结果表明,肥胖不会改变RA患者中托法替布的药物留存率。单变量分析报告肥胖患者的药物留存率可能较高;然而,多变量分析缺乏统计学意义以及该研究的回顾性性质,需要进一步研究来验证这些观察结果,并为该人群指导个性化治疗策略。

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