Second‐Line Antirheumatic Drugs in the Elderly with Rheumatoid Arthritis: A Post Hoc Analysis of Three Controlled Trials
Second‐Line Antirheumatic Drugs in the Elderly with Rheumatoid Arthritis: A Post Hoc Analysis of Three Controlled Trials
复制标题
老年类风湿关节炎的二线抗风湿药物：三项对照试验的事后分析
作者：
S. Dahl;C. Samuelson;H. Williams;J. Ward;M. Karg
这项研究评估了65岁或65岁以上患者与年轻患者相比，二线抗风湿药物的相对疗效和毒性。对三项前瞻性、双盲、平行、随机、多中心试验的结果进行了重新分析，根据干预措施和患者年龄对结果进行分层。通过将患者的反应分类为：重要改善、无意义变化或疾病进展来评估疗效。通过比较不良反应引起的撤药率来分析毒性。这三项试验比较了以下治疗方法：(1)D-青霉胺10-12毫克/天与硫唑嘌呤1.25-1.5毫克/公斤/天；(2)每周肌肉注射50毫克硫代马酸金钠与奥拉诺芬6毫克/天与安慰剂比较；(3)每周脉冲式口服甲氨蝶呤7.5-15.0毫克与安慰剂比较。基线时，除了所有研究中的病程和一项研究中的血沉率外，65岁或以上的103名患者与65岁以下的485名患者相似。对于完成每项研究的患者，基于年龄的疗效结果没有显著差异。因药物不良反应而停药的比率也无明显差异。
This study assessed the relative efficacy and toxicity of second‐line antirheumatic drugs in patients 65 years of age or older compared to younger counterparts. The results of three prospective, double‐blind, parallel, randomized, multicenter trials were reanalyzed, stratifying outcomes by intervention and patient age. Efficacy was assessed by categorizing patient responses as follows: important improvement, no meaningful change, or progressive disease. Toxicity was analyzed by comparing withdrawal rates due to adverse effects. The three trials compared the following treatments: (1) d‐penicillamine 10–12 mg/day versus azathioprine 1.25‐1.5 mg/kg/day; (2) gold sodium thiomalate 50 mg intramuscularly weekly versus auranofin 6 mg/day versus placebo; and (3) pulse oral methotrexate 7.5–15.0 mg weekly versus placebo. At baseline, 103 patients age 65 or older were similar to 485 patients less than 65 years of age, with the exception of disease duration in all studies and erythrocyte sedimentation rate in one study. For patients completing each study, efficacy outcomes based on age were not significantly different. Withdrawal rates due to adverse drug reactions were also not significantly different.
影响因子：
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作者：
DEAL, CL;MEENAN, RF;COHEN, AS
通讯作者：
COHEN, AS