Infliximab in active early rheumatoid arthritis
Infliximab in active early rheumatoid arthritis
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DOI：
10.1136/ard.2003.013961
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发表时间：
2004-02-01
影响因子：
27.4
通讯作者：
Maini, RN
中科院分区：
文献类型：
--
作者：
Breedveld, FC;Emery, P;Maini, RN
目的：探讨英夫利昔单抗联合甲氨蝶呤 (MTX) 联合治疗对早期类风湿关节炎 (RA) 患者结构损伤进展的影响。方法：对 RA 抗 TNF 治疗联合治疗 (ATTRACT) 研究中早期 RA 患者的数据进行亚组分析，其中 428 名尽管进行了 MTX 治疗但仍患有活动性 RA 的患者接受了安慰剂加 MTX（仅 MTX）或英夫利昔单抗 3 mg/kg 或 10 mg/kg 每 (q) 4 或 8 周，与 MTX（英夫利昔单抗加 MTX）联合治疗 102 周。早期 RA 定义为病程不超过 3 年； 428 名患者中有 82 名 (19%) 符合这一定义。使用修改后的 van der Heijde-Sharp 评分来评估结构损坏。比较了英夫利昔单抗加 MTX 组和仅 MTX 组之间改良 van der Heijde-Sharp 总评分从基线到第 102 周的变化。结果：与仅使用 MTX 的方案相比，早期 RA 患者队列中每个英夫利昔单抗剂量方案的侵蚀和关节间隙狭窄评分从基线到第 102 周均显着下降。手脚关节均具有一致的获益。结论：英夫利昔单抗联合 MTX 在 2 年治疗期间抑制了早期 RA 患者结构损伤的进展。尽管接受了 MTX 治疗，但对活动性 RA 患者进行英夫利昔单抗早期干预可能会通过预防放射学进展和保持关节完整性来提供长期益处。
Objective: To examine the impact of the combination of infliximab plus methotrexate (MTX) on the progression of structural damage in patients with early rheumatoid arthritis (RA).Methods: Subanalyses were carried out on data for patients with early RA in the Anti-TNF Therapy in RA with Concomitant Therapy (ATTRACT) study, in which 428 patients with active RA despite MTX therapy received placebo with MTX (MTX-only) or infliximab 3 mg/kg or 10 mg/kg every (q) 4 or 8 weeks with MTX ( infliximab plus MTX) for 102 weeks. Early RA was defined as disease duration of 3 years or less; 82 of the 428 patients (19%) met this definition. Structural damage was assessed with the modified van der Heijde-Sharp score. The changes from baseline to week 102 in total modified van der Heijde-Sharp score were compared between the infliximab plus MTX groups and the MTX-only group. Results: The erosion and joint space narrowing scores from baseline to week 102 in the cohort of patients with early RA decreased significantly in each infliximab dose regimen compared with the MTX-only regimen. Consistent benefit was seen in the joints of both hands and feet.Conclusions: Infliximab combined with MTX inhibited the progression of structural damage in patients with early RA during the 2 year period of treatment. Early intervention with infliximab in patients with active RA despite MTX therapy may provide long term benefits by preventing radiographic progression and preserving joint integrity.