Baidu
map

NEJM:托法替尼治疗传统类风湿药物无应答的银屑病性关节炎

2017-10-19 zhangfan MedSci原创

研究认为,对于传统类风湿药物无应答的银屑病性关节炎患者,托法替尼表现出良好的症状控制效果,但不良事件率较高

目前口服JK激酶抑制剂托法替尼正在开展银屑病关节炎治疗的临床研究。近日研究人员公布了其对于传统抗风湿药物应答不足的银屑病性关节炎患者的治疗效果。

在为期12个月的双盲对照研究中,患者随机接受每日5mg*2的托法替尼(n=107)、10mg*2的托法替尼 (n=104)、每2周40mg的阿达木单抗 (n=106)、先接受安慰剂后在3个月后转为5mg的托法替尼(n=52)以及先接受安慰剂后在3个月后转为10mg的托法替尼(n=53)。研究的主要终点是达到美国风湿病学院症状20%改善响应(ACR20)的患者比例以及健康评估问卷-残疾指数(HAQ-DI)得分变化。

研究发现,5mg托法替尼组ACR20响应的患者比例为50%,10mg组为61%,安慰剂组为33%,阿达木单抗组为52%。平均HAQ-DI变化,5mg组为-0.35,10mg组为-0.40,安慰剂组为-0.18而阿达木单抗组为-0.38。不良事件发生率如下:5mg组为66%,10mg组为71%,安慰剂组为64-69%,而阿达木单抗组为72%。接受托法替尼治疗的患者中发生了4例肿瘤、3例严重感染以及4例带状疱疹事件。

研究认为,对于传统类风湿药物无应答的银屑病性关节炎患者,托法替尼表现出良好的症状控制效果,但不良事件率较高。

原始出处:

Philip Mease et al. Tofacitinib or Adalimumab versus Placebo for Psoriatic Arthritis. N Engl J Med. October 19, 2017.

本文系梅斯医学(MedSci)原创编译整理,转载需授权!

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1758732, encodeId=bd141e58732d1, content=<a href='/topic/show?id=1a675894241' target=_blank style='color:#2F92EE;'>#无应答#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58942, encryptionId=1a675894241, topicName=无应答)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=71ca37362043, createdName=12498717m78(暂无昵称), createdTime=Wed Sep 05 02:44:00 CST 2018, time=2018-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1740757, encodeId=23941e40757f6, content=<a href='/topic/show?id=99b09663e61' target=_blank style='color:#2F92EE;'>#银屑病性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96637, encryptionId=99b09663e61, topicName=银屑病性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5a4934807424, createdName=41514498@qq.com, createdTime=Sun May 06 22:44:00 CST 2018, time=2018-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1265546, encodeId=b254126554693, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Sat Oct 21 00:44:00 CST 2017, time=2017-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1333935, encodeId=bb871333935c8, content=<a href='/topic/show?id=5306e6164b6' target=_blank style='color:#2F92EE;'>#类风湿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76164, encryptionId=5306e6164b6, topicName=类风湿)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq2AGzrugK9ZUjU3eJxzM901ophWib0xJDrSicy49ibWl3zB5pbDto7eoR6tnzwOiaKdbq1a8PcbYFFrw/132, createdBy=6ff22500098, createdName=ms4964546379600229, createdTime=Sat Oct 21 00:44:00 CST 2017, time=2017-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=254270, encodeId=2f312542e0f5, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Thu Oct 19 10:16:38 CST 2017, time=2017-10-19, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1758732, encodeId=bd141e58732d1, content=<a href='/topic/show?id=1a675894241' target=_blank style='color:#2F92EE;'>#无应答#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58942, encryptionId=1a675894241, topicName=无应答)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=71ca37362043, createdName=12498717m78(暂无昵称), createdTime=Wed Sep 05 02:44:00 CST 2018, time=2018-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1740757, encodeId=23941e40757f6, content=<a href='/topic/show?id=99b09663e61' target=_blank style='color:#2F92EE;'>#银屑病性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96637, encryptionId=99b09663e61, topicName=银屑病性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5a4934807424, createdName=41514498@qq.com, createdTime=Sun May 06 22:44:00 CST 2018, time=2018-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1265546, encodeId=b254126554693, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Sat Oct 21 00:44:00 CST 2017, time=2017-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1333935, encodeId=bb871333935c8, content=<a href='/topic/show?id=5306e6164b6' target=_blank style='color:#2F92EE;'>#类风湿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76164, encryptionId=5306e6164b6, topicName=类风湿)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq2AGzrugK9ZUjU3eJxzM901ophWib0xJDrSicy49ibWl3zB5pbDto7eoR6tnzwOiaKdbq1a8PcbYFFrw/132, createdBy=6ff22500098, createdName=ms4964546379600229, createdTime=Sat Oct 21 00:44:00 CST 2017, time=2017-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=254270, encodeId=2f312542e0f5, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Thu Oct 19 10:16:38 CST 2017, time=2017-10-19, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1758732, encodeId=bd141e58732d1, content=<a href='/topic/show?id=1a675894241' target=_blank style='color:#2F92EE;'>#无应答#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58942, encryptionId=1a675894241, topicName=无应答)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=71ca37362043, createdName=12498717m78(暂无昵称), createdTime=Wed Sep 05 02:44:00 CST 2018, time=2018-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1740757, encodeId=23941e40757f6, content=<a href='/topic/show?id=99b09663e61' target=_blank style='color:#2F92EE;'>#银屑病性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96637, encryptionId=99b09663e61, topicName=银屑病性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5a4934807424, createdName=41514498@qq.com, createdTime=Sun May 06 22:44:00 CST 2018, time=2018-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1265546, encodeId=b254126554693, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Sat Oct 21 00:44:00 CST 2017, time=2017-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1333935, encodeId=bb871333935c8, content=<a href='/topic/show?id=5306e6164b6' target=_blank style='color:#2F92EE;'>#类风湿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76164, encryptionId=5306e6164b6, topicName=类风湿)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq2AGzrugK9ZUjU3eJxzM901ophWib0xJDrSicy49ibWl3zB5pbDto7eoR6tnzwOiaKdbq1a8PcbYFFrw/132, createdBy=6ff22500098, createdName=ms4964546379600229, createdTime=Sat Oct 21 00:44:00 CST 2017, time=2017-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=254270, encodeId=2f312542e0f5, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Thu Oct 19 10:16:38 CST 2017, time=2017-10-19, status=1, ipAttribution=)]
    2017-10-21 lmm397
  4. [GetPortalCommentsPageByObjectIdResponse(id=1758732, encodeId=bd141e58732d1, content=<a href='/topic/show?id=1a675894241' target=_blank style='color:#2F92EE;'>#无应答#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58942, encryptionId=1a675894241, topicName=无应答)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=71ca37362043, createdName=12498717m78(暂无昵称), createdTime=Wed Sep 05 02:44:00 CST 2018, time=2018-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1740757, encodeId=23941e40757f6, content=<a href='/topic/show?id=99b09663e61' target=_blank style='color:#2F92EE;'>#银屑病性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96637, encryptionId=99b09663e61, topicName=银屑病性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5a4934807424, createdName=41514498@qq.com, createdTime=Sun May 06 22:44:00 CST 2018, time=2018-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1265546, encodeId=b254126554693, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Sat Oct 21 00:44:00 CST 2017, time=2017-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1333935, encodeId=bb871333935c8, content=<a href='/topic/show?id=5306e6164b6' target=_blank style='color:#2F92EE;'>#类风湿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76164, encryptionId=5306e6164b6, topicName=类风湿)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq2AGzrugK9ZUjU3eJxzM901ophWib0xJDrSicy49ibWl3zB5pbDto7eoR6tnzwOiaKdbq1a8PcbYFFrw/132, createdBy=6ff22500098, createdName=ms4964546379600229, createdTime=Sat Oct 21 00:44:00 CST 2017, time=2017-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=254270, encodeId=2f312542e0f5, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Thu Oct 19 10:16:38 CST 2017, time=2017-10-19, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1758732, encodeId=bd141e58732d1, content=<a href='/topic/show?id=1a675894241' target=_blank style='color:#2F92EE;'>#无应答#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58942, encryptionId=1a675894241, topicName=无应答)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=71ca37362043, createdName=12498717m78(暂无昵称), createdTime=Wed Sep 05 02:44:00 CST 2018, time=2018-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1740757, encodeId=23941e40757f6, content=<a href='/topic/show?id=99b09663e61' target=_blank style='color:#2F92EE;'>#银屑病性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96637, encryptionId=99b09663e61, topicName=银屑病性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5a4934807424, createdName=41514498@qq.com, createdTime=Sun May 06 22:44:00 CST 2018, time=2018-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1265546, encodeId=b254126554693, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Sat Oct 21 00:44:00 CST 2017, time=2017-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1333935, encodeId=bb871333935c8, content=<a href='/topic/show?id=5306e6164b6' target=_blank style='color:#2F92EE;'>#类风湿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76164, encryptionId=5306e6164b6, topicName=类风湿)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq2AGzrugK9ZUjU3eJxzM901ophWib0xJDrSicy49ibWl3zB5pbDto7eoR6tnzwOiaKdbq1a8PcbYFFrw/132, createdBy=6ff22500098, createdName=ms4964546379600229, createdTime=Sat Oct 21 00:44:00 CST 2017, time=2017-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=254270, encodeId=2f312542e0f5, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Thu Oct 19 10:16:38 CST 2017, time=2017-10-19, status=1, ipAttribution=)]
    2017-10-19 戒馋,懒,贪

    谢谢分享

    0

相关资讯

Arthritis Care Res :银屑病性关节炎疾病教育与认识的不足

一项共识声明指出,银屑病性关节炎(PsA)仍有较高比例的患者诊断不足或漏诊。如患者和医师对该疾病加深认识、存在有效的筛查工具、有更加简明的方式确定何时适合转诊至风湿病医师处接受治疗,则可使患者更早接受治疗进而减轻疾病负担。根据美国国立卫生研究院的数据报告,每20个人中就有1名罹患银屑病,并发生PsA。病情较轻的患者仅数个关节受影响,病情严重者可致关节和脊柱僵硬、烧灼感、疼痛。PsA可能增高其他疾病

Lancet:银屑病性关节炎患者应严格控制其活动

对于类风湿关节炎进行早期干预和严格的炎症控制会使患者有更好的结局,但是对于银屑病性关节炎是否该使用同样策略,目前关于该方面的研究还很少。因此研究者在英国进行了一项多中心的随机对照试验,探究对早期银屑病性关节炎患者进行严格的控制能否对结局产生有利影响。该研究纳入的研究对象为≥18岁的早期银屑病性关节炎患者(症状持续时间<24个月),在试验之前没有接受改善病情或抗风湿药物治疗。研究者按1:1将其

Lancet:ustekinumab治疗银屑病性关节炎有效

银屑病是一种免疫介导的炎性疾病,约有20%的银屑病患者会存在血清阴性的关节炎,即银屑病性关节炎。银屑病患者的疾病负担较大,在合并关节炎时尤甚。环境因素和个体的遗传易感性的共同作用是银屑病和银屑病性关节炎的发病基础。来自全基因组关联扫描的数据证实存在一些共有的遗传基因易感位点,包括白介素12和23中所包含的单核苷酸多态性,从而导致各种障碍之间存在一定重叠部分。然而,因为目前的研究几乎不会关注皮肤和关

J Am Acad Dermatol:三种筛查工具有助于诊断银屑病性关节炎

通常,银屑病发生于PsA前,医生需警惕银屑病患者发生关节炎的可能性。PsA获得充分治疗的时间越晚,患者发生不可逆的关节损伤及其他改变的可能性越大。医生需要一种高度敏感的问卷表以对患者进行筛查以对潜在PsA患者进行评估。新的研究指出,有三种筛查工具可帮助诊断银屑病性关节炎(PsA),保证患者可及时接受治疗。 来自华盛顿大学和西雅图瑞典医学中心的Philip J. Mease及其研究组评估了3种

JAMA:看银屑病与葡萄膜炎如何基情四射!

牛皮癣,即银屑病,是一种炎症性皮肤病,更严重的情况下也可侵犯关节。葡萄膜炎是眼中间层的一种炎症性疾病,它与银屑病的免疫反应相似。尽管二者之间可能存在某种联系,但是银屑病或银屑病性关节炎患者发生葡萄膜炎的风险也有限。 本研究旨在更好地了解二者之间的关系,研究人员发现银屑病、银屑病性关节炎与葡萄膜炎之间具有双向的促进作用。使用全国性的数据库可满足研究人员进行如此大规模的队列研究以分析二者之间的关

Baidu
map
Baidu
map
Baidu
map