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类风湿关节炎患者自我报告的疼痛与缓解或低疾病活动度之间的关联:来自RA-BE-REAL前瞻性观察研究的数据。

Association Between Patient-Reported Pain and Remission or Low Disease Activity in Patients with Rheumatoid Arthritis: Data from RA-BE-REAL Prospective Observational Study.

作者信息

Taylor Peter C, Fakhouri Walid, Ogwu Samuel, Haladyj Ewa, de la Torre Inmaculada, Fautrel Bruno, Alten Rieke, Nash Peter, Feist Eugen

机构信息

Botnar Research Centre, Nuffield Department of Orthopaedics, Rhematology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.

Eli Lilly and Company, Indianapolis, IN, USA.

出版信息

Rheumatol Ther. 2025 Feb;12(1):109-122. doi: 10.1007/s40744-024-00732-8. Epub 2024 Dec 17.

Abstract

INTRODUCTION

We aim to assess the association of patient-reported pain and remission or low disease activity (LDA) at 3 months (M) in patients receiving baricitinib or other treatments in RA-BE-REAL.

METHODS

RA-BE-REAL reports on patients with rheumatoid arthritis (RA) who were prescribed, for the first time, baricitinib (cohort A) or a tumour necrosis factor inhibitor (TNFi) (cohort B-TNFi) or any other mode of action (OMA) (cohort B-OMA). Pain was measured using the visual analogue scale (VAS) (0-100 mm) and clinically meaningful pain improvement thresholds of ≥ 30%, ≥ 50% and ≥ 70% from baseline to 3, 6, 12 and 24 M.

RESULTS

At 3 M, the mean change from baseline (CFB) pain VAS of patients in remission/LDA was - 32.6 mm (cohort A), - 27.3 mm (cohort B-TNFi) and - 28.0 mm (cohort B-OMA). Almost half the patients who were in remission/LDA receiving baricitinib achieved ≥ 70% pain relief. At 3 M, the proportion of patients in remission/LDA with pain VAS ≤ 20 mm was 62.1% (cohort A), 55.0% (cohort B-TNFi) and 55.6% (cohort B-OMA), while for those not in remission/LDA, it was 8.5% and 8.7% (cohort A and B-TNFi, respectively) and 5.3% (B-OMA). More patients on baricitinib achieved pain improvement in all analyzed thresholds than patients in cohort B-TNFi and B-OMA at 3 M. At 24 M, - 26.2 mm (cohort A), - 20.8 mm (cohort B-TNFi) and - 16.0 mm (cohort B-OMA) mean CFBs in pain measurement were observed. For baricitinib and the other treatments, residual pain decreased with achievement of remission/LDA and was sustained up to 24 M.

CONCLUSIONS

Patients in remission/LDA receiving baricitinib are more likely to achieve pain control than patients receiving TNFi/OMA.

摘要

引言

我们旨在评估类风湿关节炎真实世界生物制剂治疗研究(RA - BE - REAL)中接受巴瑞替尼或其他治疗的患者在3个月时患者报告的疼痛与缓解或低疾病活动度(LDA)之间的关联。

方法

RA - BE - REAL报告了首次处方巴瑞替尼的类风湿关节炎(RA)患者(A组)、肿瘤坏死因子抑制剂(TNFi)的患者(B - TNFi组)或任何其他作用方式(OMA)的患者(B - OMA组)。使用视觉模拟量表(VAS,0 - 100 mm)测量疼痛,并从基线到3、6、12和24个月评估具有临床意义的疼痛改善阈值,即≥30%、≥50%和≥70%。

结果

在3个月时,缓解/LDA患者的疼痛VAS自基线的平均变化(CFB)在A组为 - 32.6 mm,B - TNFi组为 - 27.3 mm,B - OMA组为 - 28.0 mm。接受巴瑞替尼治疗且处于缓解/LDA状态的患者中,近一半实现了≥70%的疼痛缓解。在3个月时,疼痛VAS≤20 mm的缓解/LDA患者比例在A组为62.1%,B - TNFi组为55.0%,B - OMA组为55.6%;而未处于缓解/LDA状态的患者中,该比例在A组和B - TNFi组分别为8.5%和8.7%,在B - OMA组为5.3%。在3个月时,与B - TNFi组和B - OMA组的患者相比,更多接受巴瑞替尼治疗的患者在所有分析的阈值下都实现了疼痛改善。在24个月时,观察到疼痛测量的平均CFB在A组为 - 26.2 mm,B - TNFi组为 - 20.8 mm,B - OMA组为 - 16.0 mm。对于巴瑞替尼和其他治疗,随着缓解/LDA的实现,残余疼痛减少,并持续至24个月。

结论

与接受TNFi/OMA治疗的患者相比,接受巴瑞替尼治疗且处于缓解/LDA状态的患者更有可能实现疼痛控制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9e5/11751266/118bfdea9b26/40744_2024_732_Fig1_HTML.jpg

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