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托法替布治疗对类风湿关节炎患者体重和体重指数影响的分析

Analysis of the Impact of Tofacitinib Treatment on Weight and Body Mass Index in Patients With Rheumatoid Arthritis.

作者信息

Wollenhaupt Jürgen, Morel Jacques, Daien Claire, Ruyssen-Witrand Adeline, Lukas Cédric, Richez Christophe, Shapiro Andrea, Chapman Douglass S, Cros Magali, Rivas Jose L, Citera Gustavo

机构信息

Struenseehaus Centre for Rheumatology and Clinical Immunology, Hamburg, Germany.

Department of Rheumatology, Montpellier University Hospital and INSERM U1046, CNRS UMR 9214, PhyMedExp, Montpellier, France.

出版信息

ACR Open Rheumatol. 2025 May;7(5):e70040. doi: 10.1002/acr2.70040.

Abstract

OBJECTIVES

This post hoc analysis evaluated change from baseline (Δ) in weight/body mass index (BMI) and association with disease activity or lipid changes in tofacitinib-treated patients with rheumatoid arthritis (RA).

METHODS

Data up to month 12 were pooled from eight phase 3 and 3b/4 studies of patients with RA receiving tofacitinib 5 or 10 mg twice daily or tofacitinib 11 mg modified-release once daily (alone or combined with conventional synthetic disease-modifying antirheumatic drugs), or placebo. Assessments included Δweight/BMI and the proportion of patients with weight gain ≥5%, at months 3, 6, and 12. Correlations between ∆weight/∆BMI and baseline/∆Disease Activity Score in 28 joints, erythrocyte sedimentation rate (DAS28-4[ESR]), baseline C-reactive protein (CRP), and ∆lipids were assessed. Statistical analysis included a longitudinal linear mixed model for repeated measures.

RESULTS

The analysis included 5,335 patients (tofacitinib 5 mg twice daily [n = 2,349], 10 mg twice daily [n = 1,611], 11 mg once daily [n = 694], and placebo [n = 681]). Increases in least squares mean Δweight and ΔBMI were significantly greater (P < 0.05) at months 3 and 6 with all tofacitinib doses versus placebo; increases continued to month 12. Significantly greater (at least P < 0.05) proportions of tofacitinib-treated patients (all doses) had weight gain ≥5% at months 3 and 6 versus placebo. There were weak correlations between weight/BMI changes with tofacitinib and DAS28-4(ESR), baseline CRP, or lipid changes.

CONCLUSION

Patients receiving tofacitinib experienced weight and BMI changes (primarily increases) over time, with weak correlations with disease activity or lipids.

摘要

目的

本事后分析评估了托法替布治疗的类风湿关节炎(RA)患者体重/体重指数(BMI)相对于基线的变化(Δ)及其与疾病活动或血脂变化的关联。

方法

汇总了八项3期和3b/4期研究的数据,这些研究的RA患者接受每日两次5或10 mg托法替布、或每日一次11 mg缓释托法替布(单独使用或与传统合成抗风湿药物联合使用)或安慰剂治疗,随访至第12个月。评估内容包括第3、6和12个月时的Δ体重/BMI以及体重增加≥5%的患者比例。评估了Δ体重/ΔBMI与28个关节的基线/Δ疾病活动评分、红细胞沉降率(DAS28-4[ESR])、基线C反应蛋白(CRP)和Δ血脂之间的相关性。统计分析采用纵向线性混合模型进行重复测量。

结果

分析纳入了5335例患者(每日两次5 mg托法替布[n = 2349]、每日两次10 mg托法替布[n = 1611]、每日一次11 mg托法替布[n = 694]和安慰剂[n = 681])。与安慰剂相比,所有托法替布剂量组在第3和6个月时最小二乘均值Δ体重和ΔBMI的增加均显著更大(P < 0.05);这种增加持续至第12个月。与安慰剂相比,在第3和6个月时,接受托法替布治疗的患者(所有剂量组)体重增加≥5%的比例显著更高(至少P < 0.05)。托法替布治疗引起的体重/BMI变化与DAS28-4(ESR)、基线CRP或血脂变化之间存在弱相关性。

结论

接受托法替布治疗的患者体重和BMI随时间发生变化(主要是增加),与疾病活动或血脂的相关性较弱。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/307b/12062792/f67a1cfe394f/ACR2-7-e70040-g002.jpg

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