Ann Rheum Dis:利妥昔单抗的个体化定制与固定时间表方案维持ANCA相关性血管炎缓解的比较

2018-04-26 xiangting MedSci原创

利妥昔单抗的个体化定制和固定时间表方案的AAV复发率无显著差异。个体化定制组患者的利妥昔单抗输注次数较少。

这项研究旨在将维持抗中性粒细胞胞浆抗体(ANCA)相关性血管炎(AAVs)缓解的利妥昔单抗回输个体化定制方案与固定时间表方案进行比较,其中个体化定制方案基于每季的生物参数监测。

这是一项开放标签、多中心、随机对照试验。纳入新诊断或诱导治疗后完全缓解的复发性肉芽肿病伴多血管炎(GPA)或显微镜下多血管炎(MPA)患者。个体化定制组患者随机接受500mg利妥昔单抗输注,仅在CD19+ B淋巴细胞或ANCA再次出现,或直至18个月的基于每季监测的ANCA滴度显著升高时,才进行利妥昔单抗再输注。对照组在随机分组后的第0和14天、第1次输注后的第6、12和18个月接受固定500 mg利妥昔单抗输注。主要终点是由对治疗组设盲的独立评估委员会评估的28个月复发数量(新发或复发症状或Birmingham血管炎活动评分(BVAS)>0的疾病恶化)。

纳入162例患者,平均年龄60岁,女性42%,其中117例(72.2%)为GPA,45例(27.8%)为MPA。纳入前诱导治疗包括100例环磷酰胺(61.7%)、61例利妥昔单抗(37.6%)和1例甲氨蝶呤(0.6%)。在28个月时,21例患者发生了22次复发:81例个体化定制输注患者中有13例出现14次复发(17.3%),81例固定时间表方案患者中有8例出现8次复发(9.9%)(p = 0.22)。个体化定制输液组vs.固定时间组分别接受248 vs. 381次输注,中位数(IQR)为3(2-4)vs.5(5-5)次输注。

利妥昔单抗的个体化定制和固定时间表方案的AAV复发率无显著差异。个体化定制组患者的利妥昔单抗输注次数较少。

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    2018-04-28 Boyinsh
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    2018-04-27 owlhealth

    不错耶.学习了

    0

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AAV患者甲状腺疾病的患病率高于一般人群。而这并不能归因于抗甲状腺药物。

BMC Immunol:RF是ANCA相关性血管炎病情活动的炎症标志物

摘要 背景:有些ANCA相关性血管炎(AAV)患者也有类风湿因子(RF)阳性。然而AAV患者中其临床意义未明。本研究的目的是阐明AAV患者中存在RF与患者临床特点的相关性。