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本文引用的文献

1
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Arthritis Care Res (Hoboken). 2025 Apr 2. doi: 10.1002/acr.25537.
2
Comparison of two strategies of glucocorticoid withdrawal in patients with rheumatoid arthritis in low disease activity (STAR): a randomised, placebo- controlled, double-blind trial.低疾病活动度类风湿关节炎患者糖皮质激素撤药两种策略的比较(STAR):一项随机、安慰剂对照、双盲试验
Ann Rheum Dis. 2025 Jan;84(1):49-59. doi: 10.1136/ard-2024-226620. Epub 2025 Jan 2.
3
Prevalence of polypharmacy and drug interaction in older adults with rheumatic disease.老年风湿性疾病患者的药物滥用和药物相互作用的流行情况。
Reumatol Clin (Engl Ed). 2024 May;20(5):249-253. doi: 10.1016/j.reumae.2024.02.010.
4
Formation and clinical effects of anti-drug antibodies against biologics in psoriasis treatment: An analysis of current evidence.治疗银屑病中生物制剂的抗药物抗体的形成和临床影响:对当前证据的分析。
Autoimmun Rev. 2024 Apr;23(4):103530. doi: 10.1016/j.autrev.2024.103530. Epub 2024 Mar 17.
5
Comparing methotrexate monotherapy with methotrexate plus leflunomide combination therapy in psoriatic arthritis (COMPLETE-PsA): a double-blind, placebo-controlled, randomised, trial.甲氨蝶呤单药疗法与甲氨蝶呤联合来氟米特治疗银屑病关节炎的比较(COMPLETE-PsA):一项双盲、安慰剂对照、随机试验。
Lancet Rheumatol. 2022 Apr;4(4):e252-e261. doi: 10.1016/S2665-9913(22)00028-5. Epub 2022 Feb 28.
6
The effect of polypharmacy on rheumatoid and psoriatic arthritis treatment: retrospective study.多药治疗对类风湿性关节炎和银屑病关节炎治疗的影响:回顾性研究。
PeerJ. 2023 Nov 22;11:e16418. doi: 10.7717/peerj.16418. eCollection 2023.
7
The efficacy of statins in the treatment of rheumatoid arthritis: A systematic review and meta-analysis.他汀类药物治疗类风湿关节炎的疗效:系统评价和荟萃分析。
Medicine (Baltimore). 2023 Sep 15;102(37):e35088. doi: 10.1097/MD.0000000000035088.
8
Fatal low-dose methotrexate toxicity: A case report and literature review.致命性低剂量甲氨蝶呤中毒:病例报告及文献复习。
Dermatol Ther. 2022 Dec;35(12):e15945. doi: 10.1111/dth.15945. Epub 2022 Nov 14.
9
Safety of the Methotrexate-leflunomide Combination in Rheumatoid Arthritis: Results of a Multicentric, Registry-based, Cohort Study (BiobadaBrasil).甲氨蝶呤-来氟米特联合治疗类风湿关节炎的安全性:一项多中心、基于注册的队列研究结果(BiobadaBrasil)。
J Rheumatol. 2021 Oct;48(10):1519-1527. doi: 10.3899/jrheum.201248. Epub 2021 May 1.
10
Polypharmacy Management in Older Patients.老年患者的多种药物治疗管理。
Mayo Clin Proc. 2021 Jan;96(1):242-256. doi: 10.1016/j.mayocp.2020.06.012.

类风湿关节炎管理中的多重用药与药物相互作用

Polypharmacy and drug interactions in the management of rheumatoid arthritis.

作者信息

Boeing Lorena Batista, Fogaça Natalie Sbalqueiro, Kahlow Barbara Stadler, Skare Thelma, Nisihara Renato

机构信息

Mackenzie Evangelical School of Medicine - Curitiba (PR), Brazil.

出版信息

Rev Assoc Med Bras (1992). 2025 Aug 8;71(7):e20250151. doi: 10.1590/1806-9282.20250151. eCollection 2025.

DOI:10.1590/1806-9282.20250151
PMID:40802417
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12341406/
Abstract

BACKGROUND

Rheumatoid arthritis is a chronic inflammatory disease that often necessitates combination therapy. The presence of comorbidities, frequently observed in rheumatoid arthritis patients, can further increase the number of medications required, raising the risk of drug-to-drug interactions.

OBJECTIVE

This study aimed to analyze the prevalence of polypharmacy and identify potential drug-to-drug interactions in rheumatoid arthritis patients using the MedScape® digital platform.

METHODS

A retrospective analysis was conducted on 370 rheumatoid arthritis patients. Data on epidemiological characteristics, comorbidities, and the number of medications used during treatment were collected. The MedScape® platform was employed to assess potential drug-to-drug interactions.

RESULTS

Polypharmacy was observed in 81.1% of the patients, with a higher prevalence among older individuals and those with multiple comorbidities. The MedScape® platform identified 2,018 potential drug-to-drug interactions in the sample, of which 27.5% were mild, 54.4% moderate, and 17.8% severe. Severe interactions frequently involved combinations of antirheumatic drugs.

CONCLUSIONS

Polypharmacy is highly prevalent in rheumatoid arthritis treatment, particularly in patients with comorbidities, increasing the risk of clinically significant drug-to-drug interactions. Physicians should remain vigilant in monitoring for potential interactions and adopt strategies to mitigate the risks, such as regular medication reviews and utilizing digital platforms to support clinical decision-making. This approach is critical to optimizing patient safety and treatment outcomes in rheumatoid arthritis care.

摘要

背景

类风湿关节炎是一种慢性炎症性疾病,常常需要联合治疗。类风湿关节炎患者中经常观察到合并症的存在,这可能会进一步增加所需药物的数量,从而提高药物相互作用的风险。

目的

本研究旨在使用MedScape®数字平台分析类风湿关节炎患者中多重用药的患病率,并识别潜在的药物相互作用。

方法

对370例类风湿关节炎患者进行回顾性分析。收集了流行病学特征、合并症以及治疗期间使用药物数量的数据。使用MedScape®平台评估潜在的药物相互作用。

结果

81.1%的患者存在多重用药情况,在老年人和患有多种合并症的患者中患病率更高。MedScape®平台在样本中识别出2018种潜在的药物相互作用,其中27.5%为轻度,54.4%为中度,17.8%为重度。严重的相互作用经常涉及抗风湿药物的联合使用。

结论

多重用药在类风湿关节炎治疗中非常普遍,尤其是在合并症患者中,增加了具有临床意义的药物相互作用的风险。医生应保持警惕,监测潜在的相互作用,并采取策略降低风险,如定期进行药物审查和利用数字平台支持临床决策。这种方法对于优化类风湿关节炎护理中的患者安全和治疗结果至关重要。