Higher doses of methotrexate associated with discontinuation of oral glucocorticoids after initiation of biological DMARDs: A retrospective observational study based on data from a Japanese multicenter registry study
Higher doses of methotrexate associated with discontinuation of oral glucocorticoids after initiation of biological DMARDs: A retrospective observational study based on data from a Japanese multicenter registry study
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开始生物 DMARD 后较高剂量的甲氨蝶呤与停用口服糖皮质激素相关：一项基于日本多中心注册研究数据的回顾性观察研究
DOI：
10.1080/14397595.2021.1879428
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发表时间：
2021
影响因子：
2.2
通讯作者：
Ishiguro Naoki
中科院分区：
文献类型：
--
作者：
Suzuki M;Kojima T;Takahashi Nobunori;Asai S;Terabe K;Kaneko A;Hirano Y;Hanabayashi M;Oguchi T;Takagi H;Kanayama Y;Yabe Y;Funahashi K;Fujibayashi T;Tsuboi S;Ito T;Yoshioka Y;Ishikawa H;Sobue Yi;Nishiume T;Yokota Y;Ishiguro Naoki
糖皮质激素是治疗类风湿关节炎的重要药物。鉴于糖皮质激素的副作用，我们建议尽快停用糖皮质激素，但许多患者仍长期口服糖皮质激素。本研究的目的是探讨相关因素与糖皮质激素停药后52周开始生物疾病修饰抗风湿药物（bDMARDs）。MethodsSubjects是564例患者从日本多中心注册谁是管理糖皮质激素和甲氨蝶呤（MTX），其次是开始的第一个bDMARD。我们研究了口服糖皮质激素的使用状态，在52周后开始的第一bDMARD.ResultsBy 52周后bDMARD启动，164例（29.1%）停止糖皮质激素。多变量分析确定年龄、MTX剂量和糖皮质激素剂量是与糖皮质激素停药独立相关的因素。在使用倾向评分匹配调整基线特征后，在MTX ≤ 8 mg/周和MTX > 8 mg/周的患者组中，仍有105对。甲氨蝶呤> 8 mg/week. ConclusionOur的研究结果表明，糖皮质激素的停药率（41.0%）显着较高的患者注意到MTX > 8 mg/week.ConclusionOur的研究结果表明，糖皮质激素可能会停止启动bDMARDs后。此外，在bDMARD治疗的患者中，开始bDMARD时较高的MTX剂量（>8 mg/周）与糖皮质激素停药相关。
ObjectiveGlucocorticoids are important drugs used to treat rheumatoid arthritis. We recommend glucocorticoid discontinuation as soon as possible given the associated side-effects, but many patients continue to take oral glucocorticoids long-term. The present study aimed to explore factors associated with glucocorticoid discontinuation at 52 weeks after initiating biological disease-modifying antirheumatic drugs (bDMARDs).MethodsSubjects were 564 patients from a Japanese multicenter registry who were administered glucocorticoids and methotrexate (MTX) followed by initiation of the first bDMARD. We examined the status of oral glucocorticoid use at 52 weeks after initiating the first bDMARD.ResultsBy 52 weeks after bDMARD initiation, 164 patients (29.1%) discontinued glucocorticoids. Multivariable analysis identified age, MTX dose, and glucocorticoid dose as factors independently associated with glucocorticoid discontinuation. After adjusting for baseline characteristics using propensity score matching, among patient groups administered MTX ≤ 8 mg/week and MTX > 8 mg/week, 105 pairs remained. A significantly higher rate of glucocorticoid discontinuation (41.0%) was noted for patients administered MTX > 8 mg/week.ConclusionOur findings suggest that glucocorticoids may be discontinued after initiating bDMARDs. Moreover, higher MTX doses (>8 mg/week) at the time of bDMARD initiation were associated with glucocorticoid discontinuation among patients treated with bDMARDs.