类风湿关节炎的二线（病情改善）治疗：何种药物适用于何种患者？
Second line (disease modifying) treatment in rheumatoid arthritis: which drug for which patient?
作者信息
Capell H A, Porter D R, Madhok R, Hunter J A
机构信息
Centre for Rheumatic Diseases, Glasgow Royal Infirmary, United Kingdom.
出版信息
Ann Rheum Dis. 1993 Jun;52(6):423-8. doi: 10.1136/ard.52.6.423.
Abstract
OBJECTIVES
The objectives were to assess (a) the comparative merits of commonly used disease modifying drugs in the treatment of rheumatoid arthritis (RA) and (b) the influence of age, gender, and disease duration on the outcome of treatment.
METHODS
Collected analysis (meta-analysis) was performed on results obtained during the first year of treatment in 1140 patients with RA treated with gold, penicillamine, sulphasalazine, or auranofin from a single centre.
RESULTS
Gold, penicillamine, and sulphasalazine performed similarly, with about 60% of patients continuing to receive each of these drugs for at least one year. Neither gender nor age had an influence on the response to treatment, but patients with a longer disease duration showed a greater tendency to stop treatment. The median percentage improvement was 33% in visual analogue pain score and 50% in erythrocyte sedimentation rate.
CONCLUSIONS
Routine use of these drugs should at least equal these results. Any new drug should either be substantially less toxic or at least as efficacious.
摘要
目的
本研究旨在评估（a）常用改善病情药物治疗类风湿关节炎（RA）的相对优势，以及（b）年龄、性别和病程对治疗结果的影响。
方法
对来自单一中心的1140例接受金制剂、青霉胺、柳氮磺胺吡啶或金诺芬治疗的RA患者治疗第一年的结果进行汇总分析（荟萃分析）。
结果
金制剂、青霉胺和柳氮磺胺吡啶的疗效相似，约60%的患者持续使用每种药物至少一年。性别和年龄均不影响治疗反应，但病程较长的患者停药倾向更大。视觉模拟疼痛评分的中位数改善百分比为33%，红细胞沉降率为50%。
结论
这些药物的常规使用至少应达到这些结果。任何新药要么毒性显著更低，要么至少疗效相当。
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本文引用的文献
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Sulphasalazine in rheumatoid arthritis: a double blind comparison of sulphasalazine with placebo and sodium aurothiomalate.柳氮磺胺吡啶治疗类风湿性关节炎：柳氮磺胺吡啶与安慰剂及金硫代苹果酸钠的双盲对照研究
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