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Ann Rheum Dis:早期类风湿关节炎:甲氨蝶呤+泼尼松的长期结局如何?

2017-08-04 门鹏 环球医学资讯

2017年8月,发表在《Ann Rheum Dis》的一项早期类风湿关节炎二次计算机辅助管理试验的随访调查了基于甲氨蝶呤的治疗策略联合每天10mg泼尼松的长期结局。

2017年8月,发表在《Ann Rheum Dis》的一项早期类风湿关节炎二次计算机辅助管理试验的随访调查了基于甲氨蝶呤的治疗策略联合每天10mg泼尼松的长期结局。

目的:早期类风湿关节炎二次计算机辅助管理试验中,患者开始甲氨蝶呤和10mg泼尼松(MTX+pred)或安慰剂(MTX+plac)治疗。若可能,试验后,泼尼松减量并停用。研究目的为比较两个之前治疗组间,在试验后的随访期,初始生物类改善病情抗风湿药物(bDMARD)、影像学结局和糖皮质激素(GC)相关合并症的发病。

方法:回顾性收集泼尼松和bDMARD使用的数据和GC相关合并症的发病等数据。进行了Sharp / van der Heijde评分。使用Fisher精确与Mann Whitney u检验分析数据。

结果:218名患者的试验后随访数据可用。最大随访时间为11.8年。与MTX+plac相比,之前MTX+pred组首次初始bDMARD的患者较少:31% vs 50%,P=0.003。试验后随访2年时,与MTX+plac相比,之前MTX+pred组的中位侵蚀评分显着性低:0(范围,0~0)vs 0(0~2),P=0.002。试验后的随访期,两组在GC相关合并症的发病上无显着性差异。

结论:在基于MTX的治疗方案中,每天加入10mg的泼尼松会造成早期类风湿关节炎患者较低的首次bDMARD的初始率和显着性更好的影像学结局,然而并不造成更多的GC相关合并症。

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    2017-08-06 lmm397
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  6. [GetPortalCommentsPageByObjectIdResponse(id=2012345, encodeId=31e92012345be, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Tue Mar 27 19:14:00 CST 2018, time=2018-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1265487, encodeId=6095126548e5b, 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=70, 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=Sun Aug 06 02:14:00 CST 2017, time=2017-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1333897, encodeId=f5bb133389e89, 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=63, 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=Sun Aug 06 02:14:00 CST 2017, time=2017-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385093, encodeId=1e601385093db, content=<a href='/topic/show?id=99d99e03311' target=_blank style='color:#2F92EE;'>#长期结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97033, encryptionId=99d99e03311, topicName=长期结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Sun Aug 06 02:14:00 CST 2017, time=2017-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1597301, encodeId=bfcb159e301ca, 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=73, 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=Sun Aug 06 02:14:00 CST 2017, time=2017-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229958, encodeId=cd742299581e, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Fri Aug 04 13:29:32 CST 2017, time=2017-08-04, status=1, ipAttribution=)]
    2017-08-04 哈哈869

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