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奥洛昔单抗对类风湿关节炎慢性疼痛的影响:PROLOGUE 观察性研究结果。

Olokizumab effect on chronic pain in rheumatoid arthritis: Results of the PROLOGUE observational study.

机构信息

V.A. Nasonova Research Institute of Rheumatology, Moscow, Russian Federation.

Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation.

出版信息

Int J Rheum Dis. 2024 Oct;27(10):e15320. doi: 10.1111/1756-185X.15320.

Abstract

AIM

Evaluate the efficacy and safety ® (olokizumab) in patients with rheumatoid arthritis (RA) in real-world clinical practice, with a targeted assessment of patient report outcomes (PRO) and central sensitization.

METHODS

An open-label observational non-interventional study was conducted, enrolling 183 patients with moderate and severe RA activity. All patients received OKZ 64 mg SC as injections every 4 weeks (Q4W) with methotrexate. The patients' follow-up period was 24 weeks or less. RA activity (DAS28-CRP), pain severity (NRS), patient global assessment (PGA, NRS), functional impairment (NRS), fatigue (FACIT-F), central sensitization (central sensitization inventory, CSI), and symptoms of neuropathic pain (PainDETECT) were evaluated.

RESULTS

The study cohort was comprised of 144 patients. And 39 patients were lost to follow-up, refused OKZ treatment, or were not dosed with OKZ for administrative reasons. In 6 months, DAS28-CRP decreased to 3.3 ± 0.9 (p < .001) and statistically significant reductions in pain intensity, PGA, functional impairment, and fatigue were achieved. Pain intensity decreased as early as 2 days after the first OKZ administration (p < .05). The number of patients with CSI >40 in 24 weeks decreased from 71.0% to 21.0% (p < .001), with PainDETECT >18 - from 21.5% to 13.2%. NSAIDs use decreased from 70.8% to 33.8% (р < .001), steroids - from 54.2% to 32.6%. AEs were reported in 14.2% patients, serious events were observed in three patients.

CONCLUSION

OKZ is effective in reducing RA activity and controlling chronic pain related to dysfunction of the nociceptive system.

摘要

目的

评估 ®(奥洛昔单抗)在真实临床环境中治疗类风湿关节炎(RA)患者的疗效和安全性,重点评估患者报告结局(PRO)和中枢敏化。

方法

开展一项开放性、观察性、非干预性研究,纳入 183 例中度和重度 RA 活动度的患者。所有患者均接受 OKZ 64mg SC 每 4 周(Q4W)注射治疗,同时接受甲氨蝶呤治疗。患者的随访期为 24 周或更短。评估 RA 活动度(DAS28-CRP)、疼痛严重程度(NRS)、患者总体评估(PGA,NRS)、功能障碍(NRS)、疲劳(FACIT-F)、中枢敏化(中枢敏化量表,CSI)和神经病理性疼痛症状(PainDETECT)。

结果

研究队列包括 144 例患者。39 例患者失访、拒绝 OKZ 治疗或因管理原因未接受 OKZ 治疗。6 个月时,DAS28-CRP 降至 3.3±0.9(p<0.001),疼痛强度、PGA、功能障碍和疲劳均有显著改善。首次 OKZ 给药后 2 天疼痛强度即开始下降(p<0.05)。24 周时,CSI>40 的患者比例从 71.0%降至 21.0%(p<0.001),PainDETECT>18 的患者比例从 21.5%降至 13.2%。NSAIDs 的使用率从 70.8%降至 33.8%(p<0.001),皮质类固醇的使用率从 54.2%降至 32.6%。14.2%的患者报告出现不良反应,3 例患者出现严重事件。

结论

OKZ 可有效降低 RA 活动度,并控制与伤害性感受系统功能障碍相关的慢性疼痛。

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