Ultrasound efficacy of targeted-synthetic disease-modifying anti-rheumatic drug treatment in rheumatoid arthritis: a multicenter prospective cohort study in Japan
Ultrasound efficacy of targeted-synthetic disease-modifying anti-rheumatic drug treatment in rheumatoid arthritis: a multicenter prospective cohort study in Japan
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靶向合成缓解病情抗风湿药物治疗类风湿性关节炎的超声疗效：日本的一项多中心前瞻性队列研究
DOI：
10.1080/03009742.2021.1927389
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发表时间：
2021
影响因子：
2.1
通讯作者：
Takaoka
中科院分区：
文献类型：
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作者：
Endo Y;Kawashiri S-Y;Nishino A;Michitsuji T;Tomokawa T;Nishihata S;Okamoto M;Tsuji Y;Tsuji S;Shimizu T;Sumiyoshi R;Igawa T;Koga T;Iwamoto N;Ichinose K;Tamai M;Nakamura H;Origuchi T;Ueki Y;Yoshitama T;Eiraku N;Matsuoka N;Okada A;Fujikawa K;Otsubo H;Takaoka
目的本研究通过超声检查（US）活动评估Janus激酶（JAK）抑制剂治疗类风湿性关节炎（RA）的有效性，以及患者特征和既往治疗的影响。方法这项前瞻性研究评估了2013年6月至2020年2月期间接受JAK抑制剂治疗的53名诊断为RA的日本患者中的60次治疗开始。在53名患者中，7名患者重复入组，因为他们在不同时间接受了两种不同的JAK抑制剂治疗。期间。对于每个病例，在 6 个月的随访中评估能量多普勒 (PD) 评分的改善率。 PD 评分的中位改善率用于将病例分类为 US 缓解者或无缓解者，并比较两组之间的患者特征。结果与基线相比，临床疾病活动和 US 活动的所有指标在 3 个月时均显示出显着改善。尽管 JAK 抑制剂-周期剂组和白细胞介素 6 (IL-6) 抑制剂反应不足 (IR) 组的 US 活动往往显示出较晚的改善，但与两组的基线相比，临床疾病活动和 US 活动的所有指标在 6 个月时均显示出显着改善。多变量分析显示，同时使用甲氨蝶呤和既往生物制剂或靶向合成疾病缓解抗风湿药物 (b/tsDMARD) 治疗的 IR 与美国应答者独立且显着相关。结论 JAK 抑制剂与甲氨蝶呤联合使用且之前任何 b/tsDMARD 均未出现 IR，这表明对 RA 患者具有卓越的疗效。
ObjectiveThis study investigated the effectiveness of treatment with Janus kinase (JAK) inhibitors in rheumatoid arthritis (RA) assessed by ultrasonography (US) activity, and the influence of patient characteristics and previous treatments.MethodThis prospective study assessed 60 treatment initiations among 53 Japanese patients diagnosed with RA who underwent treatment with JAK inhibitors during June 2013 to February 2020. Of the 53 patients, seven patients were enrolled in duplicate because they were treated with two different JAK inhibitors at different periods. For each case, the improvement rate on the power Doppler (PD) score was assessed at 6 month follow-up. Median improvement rate of PD score was used to classify cases as either US responders or non-responders, and patient characteristics were compared between the two groups.ResultsAll indicators of clinical disease activity and US activity showed a significant improvement at 3 months compared with baseline. Although the JAK inhibitor-cycler group and the interleukin-6 (IL-6) inhibitor inadequate response (IR) group tended to show a later improvement for US activity, all indicators of clinical disease activity and US activity showed a significant improvement at 6 months compared with baseline for both groups. Multivariate analysis showed that concomitant methotrexate use and an IR to the previous biologic or targeted-synthetic disease-modifying anti-rheumatic drug (b/tsDMARD) treatment were independently and significantly associated with US responders.ConclusionUse of a JAK inhibitor in combination with methotrexate and an absence of IR to any previous b/tsDMARDs demonstrated superior effectiveness for patients with RA.
DOI：
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发表时间：
2010
期刊：
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影响因子：
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作者：
D. Aletaha;T. Neogi;A. Silman;Julia Funovits;D. Felson;C. Bingham;N. Birnbaum;G. Burmester;V. Byker
通讯作者：
D. Aletaha;T. Neogi;A. Silman;Julia Funovits;D. Felson;C. Bingham;N. Birnbaum;G. Burmester;V. Byker
影响因子：
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作者：
B. Haraoui
通讯作者：
B. Haraoui