实用医学杂志 ›› 2022, Vol. 38 ›› Issue (8): 1006-1011.doi: 10.3969/j.issn.1006⁃5725.2022.08.018

• 药物与临床 • 上一篇    下一篇

托法替布治疗难治性类风湿关节炎的分析

张娟1 余雅坤2 田晶晶1 黄逸晨2 朵瑞雪1 沈海丽1   

  1. 1 兰州大学第二医院风湿免疫科(兰州 730030);2 兰州大学第二临床医学院(兰州 730030)

  • 出版日期:2022-04-25 发布日期:2022-04-25
  • 通讯作者: 沈海丽 E⁃mail:shenhl@lzu.edu.cn
  • 基金资助:
    国家自然科学基金(编号:81960302);甘肃省自然科学基金(编号:21JR1RA134);兰州市科技局人才创新创业项目(编号:2019⁃RC⁃35);兰州大学第二医院 2019 年博士研究生培养专项基金(编号:YJS⁃BD⁃15)

The clinical efficacy and safety of tofacitinib for difficult ⁃ to ⁃ treat rheumatoid arthritis:A retrospective case study

ZHANG Juan*,YU Yakun,TIAN Jingjing,HUANG Yichen,DUO Ruixue,SHEN Haili.#br#   

  1. Department of Rheumatology and Immunology,Lanzhou University Second Hospital,Lanzhou 730030,China

  • Online:2022-04-25 Published:2022-04-25
  • Contact: SHEN Haili E⁃mail:shenhl@lzu.edu.cn

摘要:

目的 观察托法替布对难治性类风湿关节炎的临床疗效和安全性。方法 回顾性分析兰 州大学第二医院风湿免疫科 51 例托法替布治疗难治性类风湿关节炎患者 24 周的疗效和安全性指标。收集托法替布治疗前和治疗 4、12 24 周的疾病活动性指标 DAS28CRP、DAS28ESR、血沉(ESR)、C 反应蛋白 CRP)、28 个肿胀关节数、28 个压痛关节数和 VAS 疼痛评分指标并分析改善情况,评估治疗前后血常规、 肝肾功能等安全性指标的变化。结果 托法替布治疗 4、12 24 周相比治疗前 DAS28CRP、DAS28ESR、CRP ESR、28 个肿胀关节数、28 个压痛关节数和 VAS 疼痛指数均明显下降(P < 0.05);治疗12 24 周相比治疗 4 周,DAS28CRP、DAS28ESR、28 个肿胀关节数、28 个压痛关节数和 VAS 疼痛指数均明显下降(P < 0.05);治疗 24 周,既往未使用生物 DMARDs 患者 DAS28CRP 的临床缓解达标率优于曾使用过的患者(82.35% vs. 76.47%)。无血栓、重症感染和贫血不良事件发生。结论 托法替布能有效改善难治性类风湿关节炎患 者症状、体征和炎性指标,短期内可降低疾病活动度,安全性良好。

关键词:

难治性类风湿关节炎, 托法替布, 临床疗效, 疾病活动度, 安全性

Abstract:

Objective To explore the clinical efficacy and safety of tofacitinib in the treatment of difficult⁃ to ⁃treat rheumatoid arthritis(D2T ⁃RA). Methods Fifty ⁃one patients with D2T ⁃RA who had received therapies with tofacitinib for 24 weeks were included into this study. Disease activity indicators including disease activity score 28 joint count⁃C⁃reactive protein(DAS28CRP),disease activity score 28 joint count⁃erythrocyte sedimentation rate (DAS28ESR),erythrocyte sedimentation rate(ESR),C⁃reactive protein(CRP),swollen joints count,tender joints count,visual analogue score(VAS)and safety indicators were observed prior to treatment initiation and at weeks 4,12,and 24 after Tofacitinib treatment. Results As compared with the baselines,DAS28CRP,DAS28ESR,CRP ESR,swollen joints count,tender joints count and VAS were all significantly decreased at weeks 4,12 and 24 after tofacitinib treatment(P < 0.05). As compared with 4 weeks of treatment,DAS28CRP,DAS28ESR,swollen joints count,tender joints count and VAS were all significantly decreased at weeks 12 and 24(P < 0.05). The patients with no previous therapies with biologic DMARDs were more likely to achieve the RDA of DAS28CRP than those with prior uses of DMARDs(82.35% vs. 76.47%). No adverse events including thrombosis,severe infection,and ane⁃ mia occurred. Conclusions Tofacitinib can effectively improve symptoms,signs,and inflammatory indexes and rapidly reduce the disease activity of D2T RA in the short term. It also has a better safety.

Key words:

difficult ?to ?treat rheumatoid arthritis, tofacitinib, clinical efficacy, disease activity, safety ,