Infliximab and methotrexate in the treatment of rheumatoid arthritis
Infliximab and methotrexate in the treatment of rheumatoid arthritis
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DOI：
10.1056/nejm200011303432202
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发表时间：
2000-11-30
影响因子：
158.5
通讯作者：
Maini, RN
中科院分区：
文献类型：
--
作者：
Lipsky, PE;van der Heijde, DMFM;Maini, RN
背景：中和肿瘤坏死因子α3至6个月可减少类风湿性关节炎的症状和体征。然而，这种方法能否产生更持久的益处及其对关节损伤的影响尚不清楚。方法：我们用安慰剂或抗肿瘤坏死因子-α的嵌合单抗英夫利昔单抗治疗了428名活动期类风湿关节炎患者，每4或8周静脉注射3或10毫克/公斤体重，联合口服甲氨蝶呤54周。结果：英夫利昔单抗和甲氨蝶呤联合应用耐受性良好，类风湿关节炎症状和体征持续减轻，明显优于单用甲氨蝶呤治疗(临床有效率，51.8%比17.0%；P
Background: Neutralization of tumor necrosis factor alpha (TNF-alpha) for three to six months reduces the symptoms and signs of rheumatoid arthritis. However, the capacity of this approach to effect a more sustained benefit and its effect on joint damage are not known.Methods: We treated 428 patients who had active rheumatoid arthritis despite methotrexate therapy with placebo or infliximab, a chimeric monoclonal antibody against TNF-alpha, in intravenous doses of 3 or 10 mg per kilogram of body weight every 4 or 8 weeks in combination with oral methotrexate for 54 weeks. We assessed clinical responses with use of the criteria of the American College of Rheumatology, the quality of life with a health-status questionnaire, and the effect on joint damage radiographically.Results: The combination of infliximab and methotrexate was well tolerated and resulted in a sustained reduction in the symptoms and signs of rheumatoid arthritis that was significantly greater than the reduction associated with methotrexate therapy alone (clinical response, 51.8 percent vs. 17.0 percent; P