Effectiveness and safety of non-tumor necrosis factor inhibitor therapy for anti-human T-cell leukemia virus type 1 antibody-positive rheumatoid arthritis
Effectiveness and safety of non-tumor necrosis factor inhibitor therapy for anti-human T-cell leukemia virus type 1 antibody-positive rheumatoid arthritis
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DOI：
10.1080/14397595.2020.1847802
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发表时间：
2020-11-09
影响因子：
2.2
通讯作者：
Nakamura, Hideki
中科院分区：
文献类型：
--
作者：
Endo, Yushiro;Fukui, Shoichi;Nakamura, Hideki
目的我们的前期研究表明，抗人T细胞白血病病毒1型（HTLV-1）抗体阳性的类风湿关节炎（RA）患者使用肿瘤坏死因子（TNF）抑制剂的疗效减弱。我们的目的是评估的有效性和安全性的非TNF抑制剂抗HTLV-1抗体阳性患者RA。MethodsWe审查了RA患者谁收到阿巴西普或托珠单抗作为第一个生物制剂。我们使用的数据与TNF抑制剂治疗的患者从我们以前的研究，比较抗-HTLV-1抗体阳性患者与TNF抑制剂和非TNF抑制剂治疗的有效性，使用治疗权重的逆概率（IPTW）的方法。ResultsA共359例患者分为抗-HTLV-1抗体阴性和阳性患者的332和27，分别。在抗HTLV-1抗体阳性和阴性患者之间的临床疾病活动指数变化中未观察到统计学显著差异。使用IPTW方法的结果显示非TNF抑制剂治疗与更好的反应之间存在显著相关性。没有一个患者发展成人T细胞白血病/淋巴瘤或HTLV-1相关的脊髓病/热带痉挛性下肢轻瘫在24 wks.ConclusionOur结果表明，非TNF抑制剂治疗是安全的，有效性也没有衰减在抗HTLV-1抗体阳性患者。
ObjectivesOur previous study showed that the effectiveness of tumor necrosis factor (TNF) inhibitors was attenuated in anti-human T-cell leukemia virus type 1 (HTLV-1) antibody-positive patients with rheumatoid arthritis (RA). We aimed to evaluate the effectiveness and safety of non-TNF inhibitors in anti-HTLV-1 antibody-positive patients with RA.MethodsWe reviewed patients with RA who received abatacept or tocilizumab as the first biologic agent. We used the data of patients treated with TNF inhibitors from our previous study to compare the effectiveness between the anti-HTLV-1 antibody-positive patients treated with TNF inhibitors and non-TNF inhibitors using the inverse probability of treatment weights (IPTW) method.ResultsA total of 359 patients were divided into anti-HTLV-1 antibody-negative and -positive patients of 332 and 27, respectively. No statistically significant difference was observed in the change in the clinical disease activity index between the anti-HTLV-1 antibody-positive and -negative patients. The results using the IPTW method showed a significant association between the non-TNF inhibitors treatment and a better response. None of the patients developed adult T-cell leukemia/lymphoma or HTLV-1-associated myelopathy/tropical spastic paraparesis during the 24 weeks.ConclusionOur results indicate that non-TNF inhibitors treatment is safety, and the effectiveness is not attenuated also in anti-HTLV-1 antibody-positive patients.