5-year remission rate after the discontinuation of adalimumab in patients with rheumatoid arthritis: Long-term follow-up results of the HONOR study.
5-year remission rate after the discontinuation of adalimumab in patients with rheumatoid arthritis: Long-term follow-up results of the HONOR study.
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类风湿关节炎患者停用阿达木单抗后 5 年缓解率：HONOR 研究的长期随访结果。
DOI：
10.1080/14397595.2019.1702141
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Tanaka Y.
中科院分区：
文献类型：
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作者：
Yamaguchi A;Hirata S;Kubo S;Fukuyo S;Hanami K;Nakano K;Nakayamada S;Saito K;Tanaka Y.
目的：确定类风湿性关节炎（RA）患者停用阿达木单抗（ADA）后5年随访期间与缓解（疾病活动评分（DAS） 28-红细胞沉降率(ESR) <2.6）相关的比率和因素。方法：纳入75例接受ADA +甲氨蝶呤（MTX）治疗且DAS28-ESR <2.6≥6个月的患者。其中52例患者停用ADA， 46例患者完成5年随访。结果：5年内，11例患者DAS28-ESR <2.6。在DAS28-ESR <3.2的15例患者中，健康评估问卷残疾指数（HAQ-DI）和修正夏普总分（mTSS）均无明显变化。当比较DAS28-ESR≤1.61和1.61 <DAS28-ESR <2.6的患者时，两组分别有50%和15%的患者表现出持续缓解。病程较短的患者（≤2年）比病程较长的患者（bb10 ~ 2年）缓解更常见。在31例出现耀斑的患者中，24例患者重新启动ADA，其中17例患者在1年内达到DAS28-ESR <3.2。结论：在5年无ada治疗期间，21%的患者持续缓解。无ada缓解是可能的，特别是在缓解较深（DAS28-ESR≤1.61）和病程较短（≤2年）的患者。
Objectives:To determine the rate and factors associated with remission (disease activity score (DAS) 28-erythrocyte sedimentation rate (ESR) of <2.6) during a 5-year follow-up after the discontinuation of adalimumab (ADA) in patients with rheumatoid arthritis (RA).Methods:75 patients who had been treated with ADA + methotrexate (MTX) and maintained DAS28-ESR <2.6 for at least 6 months were enrolled. Among them, 52 patients discontinued ADA, and 46 patients completed a 5-year follow-up.Results:During the 5 years, 11 patients had DAS28-ESR <2.6. In 15 patients with DAS28-ESR <3.2, no significant changes were found in the health assessment questionnaire disability index (HAQ-DI) and modified total Sharp score (mTSS). When comparing patients with DAS28-ESR ≤1.61 versus 1.61 <DAS28-ESR <2.6, 50% and 15% of the two groups demonstrated sustained remission, respectively. Remission was more common in patients with shorter disease duration (≤2 years) than those with longer duration (>2 years). Among 31 patients who experienced flare, ADA was restarted in 24 patients, and 17 patients of these achieved DAS28-ESR <3.2 within 1-year.Conclusion:During the 5-year ADA-free period, remission rate was persistent in 21% of the patients. ADA-free remission was possible especially in patients with deeper remission (DAS28-ESR ≤1.61) and shorter disease duration (≤2 years).