Effect of etanercept on fatigue in patients with recent or established rheumatoid arthritis
Effect of etanercept on fatigue in patients with recent or established rheumatoid arthritis
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DOI：
10.1002/art.21838
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发表时间：
2006-04-15
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影响因子：
--
通讯作者：
Singh, A
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文献类型：
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作者：
Moreland, LW;Genovese, MC;Singh, A
客观的。评估依那西普对新近发病（平均持续时间 11 个月）或已确诊（平均持续时间 12 年）类风湿性关节炎 (RA) 患者疲劳的长期影响。方法。纳入了参加两项多中心、随机、双盲临床试验之一的患者。在一项试验中，新发 RA 患者以双盲方式接受依那西普 25 毫克每周两次或甲氨蝶呤治疗 12 个月，然后开放标签治疗 12 个月。然后所有患者均接受开放标签依那西普治疗。在第二项试验中，确诊 RA 的患者以双盲方式每周两次接受依那西普 25 mg 或安慰剂治疗，持续 6 个月，然后开放标签依那西普。包括长达 46 个月的随访数据。使用健康评估问卷活力领域定期测量疲劳。结果。接受依那西普治疗的新发 RA 患者在前 2 个月内疲劳改善速度明显快于接受甲氨蝶呤治疗的患者。随后，接受依那西普和甲氨蝶呤治疗的患者疲劳评分分别降低了 23-29% 和 17-24%。在已确诊的 RA 组中，在盲法期间接受依那西普治疗的患者比接受安慰剂的患者疲劳程度明显减轻。最初接受依那西普治疗的患者在整个随访过程中平均疲劳程度减轻了 25-36%。获得临床上有意义的疲劳改善的患者更有可能满足美国风湿病学会的改善标准。结论。依那西普疗法可减轻新近发病或已确诊的 RA 患者的疲劳。疲劳的改善可持续长达 46 个月，并且与其他 RA 相关结果相关。
Objective. To assess the long-term impact of etanercept on fatigue in patients with recent-onset (mean duration 11 months) or established (mean duration 12 years) rheumatoid arthritis (RA).Methods. Patients participating in either of 2 multicenter, randomized, double-blind clinical trials were included. In one trial, patients with recent-onset RA received either etanercept 25 mg twice weekly or methotrexate in a double-blind fashion for 12 months, then open label for 12 months. All patients then received open-label etanercept. In the second trial, patients with established RA received etanercept 25 mg or placebo twice weekly for 6 months in a double-blinded fashion, then open-label etanercept. Up to 46 months of followup data were included. Fatigue was measured regularly using the Health Assessment Questionnaire vitality domain.Results. Patients with recent-onset RA who received etanercept had a significantly faster improvement in fatigue than those receiving methotrexate in the first 2 months. Subsequently, patients receiving etanercept and methotrexate had 23-29% and 17-24% reductions in fatigue scores, respectively. In the group with established RA, patients who received etanercept had significantly greater reductions in fatigue than those receiving placebo during the blinded period. Patients initially receiving etanercept sustained a mean fatigue reduction of 25-36% for the entire followup. Patients achieving clinically meaningful improvement in fatigue were more likely to meet the American College of Rheumatology improvement criteria.Conclusion. Etanercept therapy reduces fatigue in patients with recent-onset or established RA. Improvement in fatigue was sustained for up to 46 months, and correlated with other RA-relevant outcomes.