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J Rheumatol:类风湿关节炎患者抗环瓜氨酸蛋白抗体状态对阿巴西普或TNF-α治疗反应的影响

2017-11-09 xiangting MedSci原创

抗CCP状态与对ABA的不同治疗反应相关,而不是TNFi。

这项研究旨在评估在类风湿关节炎(RA)中,基线抗环瓜氨酸蛋白抗体(抗CCP)状态是否与开始阿巴西普(ABA)或TNF-α抑制剂(TNFi)治疗的反应相关。

使用Corrona RA登记确定开始ABA或TNFi治疗的患者(2004年6月-2015年1月),开始后随访6个月(±3个月),开始时或开始前测定抗CCP。主要结局是临床疾病活动指数(CDAI)从开始到6个月的平均变化。基于典型的患者概况(女性,年龄57岁,体重指数30kg/m2,基线CDAI为20,之前使用1种生物制剂以及除RA外无其他合并症)评估治疗反应。次要结果包括缓解和疾病活动性低。

共有566例ABA使用者[抗CCP +(≥20单位/ml):362例; 抗CCP-(<20单位/ ml):n = 204]和1715例TNFi使用者(抗CCP +:n = 1113;抗CCP-:n = 602)。治疗组间的差异包括基线疾病持续时间,CDAI和之前的生物制剂使用情况。在6个月时,抗CCP + ABA使用者与抗CCP-ABA使用者相比具有更高的CDAI反应; TNFi使用者间没有观察到显著差异。当考虑典型的RA患者概况时,抗CCP +与抗CCP-的ABA使用者比较CDAI反应更大; 抗CCP +与抗CCP-的TNFi使用者相似。抗CCP +ABA使用者的次要结果反应也比抗CCP-更大;不同抗 CCP状态的TNFi使用者反应没有差异。

在美国的临床实践中,抗CCP状态与对ABA的不同治疗反应相关,而不是TNFi。

原始出处:

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    2017-11-11 lmm397
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    2017-11-11 snowpeakxu
  5. [GetPortalCommentsPageByObjectIdResponse(id=1803960, encodeId=a7111803960e6, content=<a href='/topic/show?id=62c7e6169ed' target=_blank style='color:#2F92EE;'>#类风湿关节炎患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76169, encryptionId=62c7e6169ed, topicName=类风湿关节炎患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=智者为医08, createdTime=Mon Dec 18 12:15:00 CST 2017, time=2017-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1265567, encodeId=a445126556ef7, 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=62, 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 Nov 11 07:15:00 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1333944, encodeId=3fb91333944fa, 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=75, 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 Nov 11 07:15:00 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1401654, encodeId=f36a14016548b, content=<a href='/topic/show?id=17e21e57943' target=_blank style='color:#2F92EE;'>#TNF#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17579, encryptionId=17e21e57943, topicName=TNF)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqjVbfRD4f4vibEcZVcvato8Qib1gGtZJiayXCMFgHrkeErSiaxdYMiabKGxY2an9muxWCkUJbjFPViaC6A/132, createdBy=e4fb2361580, createdName=snowpeakxu, createdTime=Sat Nov 11 07:15:00 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1580845, encodeId=31a81580845aa, content=<a href='/topic/show?id=cc274831170' target=_blank style='color:#2F92EE;'>#巴西#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48311, encryptionId=cc274831170, topicName=巴西)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=81dd16663079, createdName=ms9833124466084992, createdTime=Sat Nov 11 07:15:00 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1597341, encodeId=b23a159e34168, content=<a href='/topic/show?id=fa1710082017' target=_blank style='color:#2F92EE;'>#风湿关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100820, encryptionId=fa1710082017, topicName=风湿关节炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=456818510265, createdName=xuruicheng, createdTime=Sat Nov 11 07:15:00 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260028, encodeId=6a6a260028bf, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmhead/Q3auHgzwzM6P57Bs8gOPaY1cQP9lIia0lmZOEXraGaoicqNToIslXDKw/0, createdBy=7a041951742, createdName=衣带渐宽, createdTime=Thu Nov 09 16:56:43 CST 2017, time=2017-11-09, status=1, ipAttribution=)]
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    2017-11-09 衣带渐宽

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