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J Rheumatol:连续与间歇性塞来昔布治疗骨性关节炎的疗效

2020-05-11 MedSci原创 MedSci原创

本研究旨在确定“连续”塞来昔布在预防膝盖和/或髋部骨关节炎(OA)耀斑方面是否比“间歇”更有效。

本研究旨在确定“连续”塞来昔布在预防膝盖和/或髋部骨关节炎(OA)耀斑方面是否比“间歇”更有效。

 

一项双盲,随机,多中心国际研究,纳入858名18-80岁的OA患者,分别接受200毫克/天的连续(每日)与间歇(根据预先确定的OA耀斑)治疗,对两组治疗的有效性和安全性进行比较。该研究包括三个阶段:(I)筛查/观察期;(II)塞来昔布的开放标签试验;(III)22周双盲治疗。仅将在第2阶段OA耀斑消退的受试者(无随后的耀斑)随机分组。使用方差分析(以治疗作为自变量)比较了主要终点,即在III期期间每次暴露的耀斑数量(每月耀斑数量)。对乙酰氨基酚可作为急救药物。

 

 结果显示,在875名随机接受治疗的受试者中,有858名受试者接受了治疗。在随机分组中> 70%是女性;平均年龄58.6岁;平均病程6.5年;西安大略省和麦克马斯特大学的总骨关节炎指数平均分25.8;约45%患有高血压;约20%的人使用阿司匹林(用于心血管预防)。接受连续治疗的受试者报告说,与间歇性使用者相比,OA复发/月减少42%(P <0.0001),或22周内OA复发减少2.0。在持续治疗中,次要疗效的统计学和临床​​获益也很明显。不良事件(AE)或新发/加重性高血压方面没有差异。

 

综上所述,该研究结果表明,在治疗的22周内,连续使用塞来昔布200mg/天的治疗在预防髋关节和膝关节的OA复发方面比间歇性使用的疗效明显要好,而不会增加包括胃肠道疾病和高血压在内的总AEs。

 

原始出处:

 

Vibeke Strand, Lee S Simon, et al., Treatment of Osteoarthritis With Continuous Versus Intermittent Celecoxib. J Rheumatol. 2011 Dec;38(12):2625-34. doi: 10.3899/jrheum.110636.  

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    2020-05-13 lmm397
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    2020-05-11 内科新手

    谢谢梅斯提供这么好的信息,学到很多

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