来自土耳其的真实世界见解：生物性改善病情抗风湿药在慢性肾脏病脊柱关节炎患者中的应用

Real-World Insights From Türkiye: Biologic DMARDs Usage in Spondyloarthritis Patients With Chronic Kidney Disease.

作者信息

Bulut Gökten Dilara, Tezcan Mehmet Engin, Yağız Burcu, Erden Abdulsamet, Kimyon Gezmiş, Yaşar Bilge Nazife Şule, Kılıç Levent, Coşkun Belkıs Nihan, Ersözlü Emine Duygu, Küçükşahin Orhan, Koca Süleyman Serdar, Gönüllü Emel, Çınar Muhammet, Akar Servet, Emmungil Hakan, Kaşifoğlu Timuçin, Bes Cemal, Ateş Aşkın, Pehlivan Yavuz, Kiraz Sedat, Ertenli Ali İhsan, Dalkılıç Hüseyin Ediz, Kalyoncu Umut, Mercan Rıdvan

机构信息

Division of Rheumatology, Department of Internal Medicine, Tekirdag Namik Kemal University, Tekirdag, Türkiye.

Division of Rheumatology, Department of Internal Medicine, Kartal Dr. Lütfi Kırdar City Hospital, Istanbul, Türkiye.

出版信息

Int J Rheum Dis. 2025 May;28(5):e70274. doi: 10.1111/1756-185X.70274.

DOI:10.1111/1756-185X.70274

PMID:40358366

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12071336/

Abstract

AIM

The objective was to evaluate biologic disease-modifying antirheumatic drugs (DMARDs) and their side effects that hindered the continuation of treatment in a patient population diagnosed with spondyloarthritis (SpA) with a glomerular filtration rate (GFR) ≤ 60 mL/min, and to compare these side effects between patients with chronic kidney disease (CKD) and those without.

METHODS

This multicenter, observational cohort study utilized data from the TReasure database, which records SpA patients in a web-based system across Türkiye. A total of 6052 patients being included. SpA patients were categorized into two main groups: non-CKD patients and CKD patients. The clinical characteristics, disease activity, treatment options, drug retention rates, reasons for drug discontinuation, and types of adverse effects were compared between the groups.

RESULTS

Biologics prescription pattern varied between CKD and non-CKD patients. Etanercept was prescribed more frequently (53.1%) in CKD patients. Regarding the number of side effects and drug discontinuations in CKD patients, no statistically significant differences were found between the non-CKD and CKD groups for any of the bDMARDs (adalimumab, etanercept, golimumab, infliximab, ustekinumab, secukinumab, and certolizumab). No statistically significant differences were observed in the duration of drug retention based on CKD status for bDMARDs.

CONCLUSION

This study offers preliminary evidence supporting the effective and safe use of bDMARDs in patients with SpA and CKD.

摘要

目的

本研究旨在评估生物性改善病情抗风湿药（DMARDs）及其副作用，这些副作用会影响肾小球滤过率（GFR）≤60 mL/min的脊柱关节炎（SpA）患者继续接受治疗，并比较慢性肾脏病（CKD）患者和非CKD患者之间的这些副作用。

方法

这项多中心观察性队列研究使用了TReasure数据库中的数据，该数据库在基于网络的系统中记录了土耳其各地的SpA患者。总共纳入了6052例患者。SpA患者被分为两个主要组：非CKD患者和CKD患者。比较了两组患者的临床特征、疾病活动度、治疗选择、药物保留率、停药原因和不良反应类型。

结果

CKD患者和非CKD患者的生物制剂处方模式有所不同。依那西普在CKD患者中的处方频率更高（53.1%）。关于CKD患者的副作用数量和停药情况，在任何一种生物DMARDs（阿达木单抗、依那西普、戈利木单抗、英夫利昔单抗、乌司奴单抗、司库奇尤单抗和赛妥珠单抗）方面，非CKD组和CKD组之间均未发现统计学上的显著差异。基于CKD状态，生物DMARDs的药物保留持续时间未观察到统计学上的显著差异。