The impact of long-term biologics/target therapy on bone mineral density in rheumatoid arthritis: a propensity score-matched analysis
The impact of long-term biologics/target therapy on bone mineral density in rheumatoid arthritis: a propensity score-matched analysis
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DOI：
10.1093/rheumatology/kez655
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发表时间：
2020-09-01
期刊：
影响因子：
5.5
通讯作者：
Cheng, Tien-Tsai
中科院分区：
文献类型：
--
作者：
Chen, Jia-Feng;Hsu, Chung-Yuan;Cheng, Tien-Tsai
目标。目的观察服用生物/靶向抗风湿药物(b/tsDMARD)和常规合成DMARD(CsDMARD)3年的RA患者骨密度的变化。RA患者入选时间为2014年9月至2019年3月。登记时记录临床特征、骨密度和脆性骨折的证据。参与者在为期3年的观察期内按照国家健康与护理卓越研究所(NICE)的指导方针进行治疗。在研究结束时重复测量骨密度。参与者被分成接受b/tsDMARD或csDMARD的患者，并根据倾向得分匹配(1：2)。共有388名参与者完成了为期3年的随访。在倾向得分匹配后，92名和184名参与者分别被分配到b/tsDMARD(I组)和csDMARD(II组)。3年后，I组股骨颈(FN)、髋部(TH)和腰椎(L1-4)的BMD均保持稳定(P=0.09，0.15，0.87)，而II组的BMD显著下降(P=0.045，P=0.045，P<0.05)。
Objectives. To investigate changes in BMD in RA patients receiving 3-year biological/targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARD) or conventional synthetic DMARD (csDMARD).Methods. Patients with RA were recruited from September 2014 until March 2019. Clinical characteristics, BMD and evidence of fragility fractures at enrolment were documented. Participants were treated according to the National Institute for Health and Care Excellence (NICE) guidelines over a 3-year observation period. Repeated BMD was measured at the end of the study period. Participants were grouped into those receiving b/tsDMARD or csDMARD and by propensity score matching (1:2).Results. A total of 388 participants completed the 3-year follow-up. After propensity score matching, 92 and 184 participants were allocated to the b/tsDMARD (Group I) and csDMARD (Group II), respectively. After 3 years, BMD remained stable at the femoral neck (FN), hip (total) (TH) and lumbar vertebra (L1-4) (P = 0.09, 0.15, 0.87) in Group I. However, BMD decreased significantly in Group II (P=0.045,