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Arthritis Rheumatol：多关节幼年特发性关节炎早期开始使用生物制剂有帮助吗？

2021-10-08 MedSci原创 MedSci原创

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在未经治疗的多关节JIA受试者中，在基线评估的3个月内开始 bDMARDs与更快实现非活动性疾病相关。这些结果证明了病程轨迹分析作为确定治疗效果的一种方法。

研究目的：研究早期使用改善疾病的抗风湿生物制剂(bDMARDs) 对未经治疗的多关节幼年特发性关节炎 (JIA) 病程的影响。

方法：研究者分析了参与多关节JIA开始时间优化研究(STOP-JIA) 中的多关节JIA患者(n = 400)和一个来自儿童关节炎和风湿病研究联盟登记处的比较队列(n = 248)的数据。潜在类轨迹建模（LCTM）应用于根据从基线开始12个月内的疾病活动（临床幼年关节炎10个关节的疾病活动评分）确定具有不同病程的患者亚组。

结果：在STOP-JIA研究中，198名受试者（49.5%）在基线评估的3个月内接受了 bDMARDs。LCTM分析生成了3个潜在类别，代表3个不同的疾病轨迹，其特征是随着时间的推移疾病活动缓慢、中度或迅速改善。快速改善轨迹中的受试者从基线开始的6个月内获得非活动性疾病。在调整人口统计学特征、临床属性和基线疾病活动性之后发现接受bDMARDs治疗的患者≤基线3个月与基线后>3个月开始bDMARDs的受试者相比，处于快速改进轨迹比缓慢改进轨迹的几率高3.6倍（95% CI 1.32–10.0；P = 0.013)。第一次风湿病就诊时的短病程作为不用bDMARD治疗的有利轨迹的预测因子接近统计学差异。

结论：在未经治疗的多关节JIA受试者中，在基线评估的3个月内开始 bDMARDs与更快实现非活动性疾病相关。这些结果证明了病程轨迹分析作为确定治疗效果的一种方法。

 

出处：

Ong MS, Ringold S, Kimura Y, Schanberg LE, Tomlinson GA, Natter MD; CARRA Registry Investigators. Improved Disease Course Associated With Early Initiation of Biologics in Polyarticular Juvenile Idiopathic Arthritis: Trajectory Analysis of a Childhood Arthritis and Rheumatology Research Alliance Consensus Treatment Plans Study. Arthritis Rheumatol. 2021 Oct;73(10):1910-1920. doi: 10.1002/art.41892. Epub 2021 Aug 27. PMID: 34105303.

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    2022-06-07 一叶知秋

    #生物制剂#

    0

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    2022-08-12 ms6390871039024434

    #Arthritis#

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    2021-10-11 xinxin088

    #特发性#

    0

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    2021-10-10 lmm397

    #关节炎#

    0

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    2021-10-10 zhaojie88

    #ART#

    0