Ann Rheum Dis :ANCA相关血管炎缓解维持方案的长期疗效

2018-05-04 xiangting MedSci原创

利妥昔单抗治疗组的持续缓解率更高,并保持60个月,总生存率更高。

这项研究旨在比较新诊断或复发性抗中性粒细胞胞浆抗体(ANCA)相关血管炎患者中缓解维持方案的长期疗效。

在系统性ANCA相关血管炎试验中使用利妥昔单抗进行了28个月的缓解维持治疗,在新诊断或复发性肉芽肿伴多血管炎、显微镜多血管炎或肾性ANCA相关血管炎患者中,比较了利妥昔单抗和硫唑嘌呤维持缓解的疗效。此后,前瞻性患者随访持续至第60个月。主要终点是第60个月的主要复发率。还评估了复发和无严重不良事件生存率。

在入选的115名患者中,只有1名失访。在60个月时,硫唑嘌呤和利妥昔单抗组的主要无复发生存率分别为49.4%(95%CI 38.0%至64.3%)和71.9%(95%CI 61.2%至84.6%)(p=0.003);轻微和主要无复发生存率分别为37.2%(95%CI 26.5%-52.2%)和57.9%(95%CI 46.4%-72.2%)(p=0.012); 总生存率分别为93.0%(95%CI 86.7%-99.9%)和100%(p=0.045),累积糖皮质激素的使用相当。无症状质量调整时间和毒性分析显示利妥昔单抗治疗患者无复发或毒性的时间比硫唑嘌呤治疗患者长12.6个月(p<0.001)。抗蛋白酶-3-ANCA阳性和硫唑嘌呤组与复发的风险较高独立相关。ANCA阳性预测复发的HRs随时间而升高。

ANCA相关血管炎患者在基于利妥昔单抗或硫唑嘌呤的维持方案后,利妥昔单抗治疗组的持续缓解率更高,并保持60个月,总生存率更高。

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    2018-05-06 Boyinsh
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    2018-05-04 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0

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    2018-05-04 虈亣靌

    好知识值得学习了

    0

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    2018-05-04 执着追梦

    学习.谢谢分享

    0

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