Arthritis Rheumatol:两个早期类风湿性关节炎队列实施不同靶向治疗策略达到缓解的情况

2020-02-29 xiangting MedSci原创

两个队列中的大多数患者均达到了研究特定的治疗目标。随访期间,ARCTIC队列比NOR-VEAC队列达到ACR/EULAR布尔缓解的人数更多,这表明以更严格的缓解定义为治疗目标有助于为TTT策略提供有利的结局。

这项研究旨在比较两个早期类风湿性关节炎(RA)靶向治疗(TTT)队列的缓解情况,其中一个为随机对照策略试验中以严格缓解为目标的严格控制队列,另一个为临床实践中以较宽松缓解定义为目标的观察性队列。

研究人员分析了来自ARCTIC试验和NOR-VEAC观察性研究的数据。两者均是纳入疾病改善抗风湿药物(DMARD)初治并实施TTT治疗RA患者的挪威多中心研究。ARCTIC的缓解目标是疾病活动性评分(DAS44<1.6加上44肿胀关节计数为0,而NOR-VEAC的缓解目标是较宽松的DAS28<2.6。文章评估了研究特定目标的实现情况,并比较了两年随访期间达到ACR/EULAR布尔缓解的情况。

纳入了189名来自ARCTIC的患者和330名来自NOR-VEAC的患者。第6个月时每个队列中超过一半的人达到了研究特定目标,在1224个月时达到了60%以上。ARCTIC随访期间达到ACR/EULAR布尔缓解的几率比NOR-VEAC高,在3个月(OR 1.7395CI 1.03-2.89)、12个月(OR 1.9795CI 1.21-3.20)和24个月(OR 1.8295CI 1.05-3.16)有统计学差异。

两个队列中的大多数患者均达到了研究特定的治疗目标。随访期间,ARCTIC队列比NOR-VEAC队列达到ACR/EULAR布尔缓解的人数更多,这表明以更严格的缓解定义为治疗目标有助于为TTT策略提供有利的结局。

原始出处:

Vibeke Norvang. Achievement of remission in two early rheumatoid arthritis cohorts implementing different treat‐to‐target strategies. Arthritis Rheumatol. February 2020.

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=1972702, encodeId=836319e270233, content=<a href='/topic/show?id=8a6a2e8839' target=_blank style='color:#2F92EE;'>#Arthritis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2788, encryptionId=8a6a2e8839, topicName=Arthritis)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIibticIBly5jCSic5ZElW4He3rO4DMpUHUFaFX57OicNMnzckWaicBNeStwugWHFCuOdicoakApM4HGmtw/132, createdBy=f8672500006, createdName=ms6390871039024434, createdTime=Wed Apr 01 08:07:00 CST 2020, time=2020-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266116, encodeId=9fde12661161a, 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=35, 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=Mon Mar 02 05:07:00 CST 2020, time=2020-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1334209, encodeId=c8ce1334209f9, 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=40, 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=Mon Mar 02 05:07:00 CST 2020, time=2020-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357410, encodeId=ee54135e41024, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Mon Mar 02 05:07:00 CST 2020, time=2020-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483658, encodeId=15e01483658f7, content=<a href='/topic/show?id=55a6100826cc' target=_blank style='color:#2F92EE;'>#风湿性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100826, encryptionId=55a6100826cc, topicName=风湿性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c237911872, createdName=ms1467340776200723, createdTime=Mon Mar 02 05:07:00 CST 2020, time=2020-03-02, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1972702, encodeId=836319e270233, content=<a href='/topic/show?id=8a6a2e8839' target=_blank style='color:#2F92EE;'>#Arthritis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2788, encryptionId=8a6a2e8839, topicName=Arthritis)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIibticIBly5jCSic5ZElW4He3rO4DMpUHUFaFX57OicNMnzckWaicBNeStwugWHFCuOdicoakApM4HGmtw/132, createdBy=f8672500006, createdName=ms6390871039024434, createdTime=Wed Apr 01 08:07:00 CST 2020, time=2020-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266116, encodeId=9fde12661161a, 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=35, 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=Mon Mar 02 05:07:00 CST 2020, time=2020-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1334209, encodeId=c8ce1334209f9, 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=40, 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=Mon Mar 02 05:07:00 CST 2020, time=2020-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357410, encodeId=ee54135e41024, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Mon Mar 02 05:07:00 CST 2020, time=2020-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483658, encodeId=15e01483658f7, content=<a href='/topic/show?id=55a6100826cc' target=_blank style='color:#2F92EE;'>#风湿性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100826, encryptionId=55a6100826cc, topicName=风湿性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c237911872, createdName=ms1467340776200723, createdTime=Mon Mar 02 05:07:00 CST 2020, time=2020-03-02, status=1, ipAttribution=)]
    2020-03-02 lmm397
  3. [GetPortalCommentsPageByObjectIdResponse(id=1972702, encodeId=836319e270233, content=<a href='/topic/show?id=8a6a2e8839' target=_blank style='color:#2F92EE;'>#Arthritis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2788, encryptionId=8a6a2e8839, topicName=Arthritis)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIibticIBly5jCSic5ZElW4He3rO4DMpUHUFaFX57OicNMnzckWaicBNeStwugWHFCuOdicoakApM4HGmtw/132, createdBy=f8672500006, createdName=ms6390871039024434, createdTime=Wed Apr 01 08:07:00 CST 2020, time=2020-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266116, encodeId=9fde12661161a, 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=35, 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=Mon Mar 02 05:07:00 CST 2020, time=2020-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1334209, encodeId=c8ce1334209f9, 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=40, 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=Mon Mar 02 05:07:00 CST 2020, time=2020-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357410, encodeId=ee54135e41024, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Mon Mar 02 05:07:00 CST 2020, time=2020-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483658, encodeId=15e01483658f7, content=<a href='/topic/show?id=55a6100826cc' target=_blank style='color:#2F92EE;'>#风湿性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100826, encryptionId=55a6100826cc, topicName=风湿性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c237911872, createdName=ms1467340776200723, createdTime=Mon Mar 02 05:07:00 CST 2020, time=2020-03-02, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1972702, encodeId=836319e270233, content=<a href='/topic/show?id=8a6a2e8839' target=_blank style='color:#2F92EE;'>#Arthritis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2788, encryptionId=8a6a2e8839, topicName=Arthritis)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIibticIBly5jCSic5ZElW4He3rO4DMpUHUFaFX57OicNMnzckWaicBNeStwugWHFCuOdicoakApM4HGmtw/132, createdBy=f8672500006, createdName=ms6390871039024434, createdTime=Wed Apr 01 08:07:00 CST 2020, time=2020-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266116, encodeId=9fde12661161a, 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=35, 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=Mon Mar 02 05:07:00 CST 2020, time=2020-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1334209, encodeId=c8ce1334209f9, 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=40, 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=Mon Mar 02 05:07:00 CST 2020, time=2020-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357410, encodeId=ee54135e41024, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Mon Mar 02 05:07:00 CST 2020, time=2020-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483658, encodeId=15e01483658f7, content=<a href='/topic/show?id=55a6100826cc' target=_blank style='color:#2F92EE;'>#风湿性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100826, encryptionId=55a6100826cc, topicName=风湿性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c237911872, createdName=ms1467340776200723, createdTime=Mon Mar 02 05:07:00 CST 2020, time=2020-03-02, status=1, ipAttribution=)]
    2020-03-02 zhaojie88
  5. [GetPortalCommentsPageByObjectIdResponse(id=1972702, encodeId=836319e270233, content=<a href='/topic/show?id=8a6a2e8839' target=_blank style='color:#2F92EE;'>#Arthritis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2788, encryptionId=8a6a2e8839, topicName=Arthritis)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIibticIBly5jCSic5ZElW4He3rO4DMpUHUFaFX57OicNMnzckWaicBNeStwugWHFCuOdicoakApM4HGmtw/132, createdBy=f8672500006, createdName=ms6390871039024434, createdTime=Wed Apr 01 08:07:00 CST 2020, time=2020-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266116, encodeId=9fde12661161a, 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=35, 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=Mon Mar 02 05:07:00 CST 2020, time=2020-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1334209, encodeId=c8ce1334209f9, 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=40, 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=Mon Mar 02 05:07:00 CST 2020, time=2020-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357410, encodeId=ee54135e41024, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Mon Mar 02 05:07:00 CST 2020, time=2020-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483658, encodeId=15e01483658f7, content=<a href='/topic/show?id=55a6100826cc' target=_blank style='color:#2F92EE;'>#风湿性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100826, encryptionId=55a6100826cc, topicName=风湿性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c237911872, createdName=ms1467340776200723, createdTime=Mon Mar 02 05:07:00 CST 2020, time=2020-03-02, status=1, ipAttribution=)]

相关资讯

Ann Rheum Dis:类风湿性关节炎靶向治疗真有效吗?患者队列纵向分析(RA BIODAM)

在日常临床实践中,对RA患者正确应用T2T策略(尤其是持续性T2T)使得缓解率更高。

Ann Rheum Dis:超早期使用依那西普和MTX vs MTX联合依那西普延迟治疗RA的随机对照试验

与既往报告的肿瘤坏死因子抑制剂+MTX一线治疗缓解率vs MTX-TT相比,这项研究并未证实在ERA中ETN+MTX有更大疗效。

Ann Rheum Dis:类风湿性关节炎的流行病学正在改变吗?1985-2014年人群发病率研究结果

使用1987 ACR标准,与前20年相比,2005-2014年RF阴性RA的发病率明显升高,而RF阳性RA的发病率下降。

Ann Rheum Dis:血清代谢组和脂质组差异确定了血清阴性类风湿性关节炎vs银屑病关节炎的潜在生物标志物

PsA和negRA具有不同的血清代谢组学和脂质组学特征,可以用作鉴别诊断的生物标志物。

2019 EULAR建议:应用合成或生物类改善病情抗风湿药治疗类风湿性关节炎

2020年1月,欧洲抗风湿病联盟(EULAR)发布了应用合成或生物类改善病情抗风湿药治疗类风湿性关节炎指南,本文主要提供了更新的类风湿关节炎管理建议,共包括5条总体原则和12条具体推荐意见。

J Rheumatol:IL-17A和IL-17F在类风湿性关节炎和外周型脊椎关节炎中的表达及功能反应

SpA滑膜炎的IL-17A/IL-17F表达率高于银屑病皮肤。然而,在SpA和RA滑膜炎中,IL-17A和IL-17F的表达以及对这些细胞因子的功能应答似乎相同。