{"title":"用生物制剂和 JAK-STAT 抑制剂治疗严重类风湿性关节炎患者的比较。一项观察性研究。","authors":"Małgorzata Wisłowska","doi":"10.5114/reum.2022.115987","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Treatment of severe rheumatoid arthritis (RA) is currently based either on biological agents or Janus kinase/signal transducer and activator of transcription inhibitors, most often in combination with methotrexate (MTX).</p><p><strong>Aim of the study: </strong>The aim of the study was to compare the effectiveness and side effects of bio- logic disease-modifying antirheumatic drugs (bDMARDs) and targeted synthetic (ts) DMARDs treatment.</p><p><strong>Material and methods: </strong>The analysis included 108 RA patients with active disease treated with MTX 25 mg per week. Eighty patients (group I) were treated with bDMARDs and 28 patients (group II) with JAK-STAT inhibitors. The duration of morning stiffness, pain on Visual Analogue Scale (VAS), 28-joints Disease Activity Score (DAS28) and Simplified Disease Activity Score (SDAI) were assessed. Classical radiographic images of patients' hands and feet using the Larsen and Dale's criteria were evaluated. The effects of treatment with bDMARDs and tsDMARDs were analyzed.</p><p><strong>Results: </strong>All studied patients presented at least Larsen and Dale's stage 3 of X-ray changes typical for RA. There were no statistically significant differences in disease duration, ESR, CRP, DAS28 and SDAI values between studied groups. Patients from group II previously used higher numbers of bDMARDs than group I treated with bDMARDs. Low disease activity after treatment was achieved by all patients; therefore patients from group II (treated with tsDMARDs) achieved lower values of patients' global assessment on VAS.</p><p><strong>Conclusions: </strong>The results of the present observational study indicated that treatment with JAK inhibitors is very promising. These drugs are not inferior in effectiveness to bDMARDs. It is important to monitor patients for thromboembolic events before and during JAK treatment.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0e/35/RU-60-46973.PMC9238315.pdf","citationCount":"0","resultStr":"{\"title\":\"Comparison of treatment of severe rheumatoid arthritis patients with biological agents and JAK-STAT inhibitors. 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The duration of morning stiffness, pain on Visual Analogue Scale (VAS), 28-joints Disease Activity Score (DAS28) and Simplified Disease Activity Score (SDAI) were assessed. Classical radiographic images of patients' hands and feet using the Larsen and Dale's criteria were evaluated. The effects of treatment with bDMARDs and tsDMARDs were analyzed.</p><p><strong>Results: </strong>All studied patients presented at least Larsen and Dale's stage 3 of X-ray changes typical for RA. There were no statistically significant differences in disease duration, ESR, CRP, DAS28 and SDAI values between studied groups. Patients from group II previously used higher numbers of bDMARDs than group I treated with bDMARDs. Low disease activity after treatment was achieved by all patients; therefore patients from group II (treated with tsDMARDs) achieved lower values of patients' global assessment on VAS.</p><p><strong>Conclusions: </strong>The results of the present observational study indicated that treatment with JAK inhibitors is very promising. These drugs are not inferior in effectiveness to bDMARDs. 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引用次数: 0
摘要
导言:目前,治疗严重类风湿性关节炎(RA)的药物主要是生物制剂或Janus激酶/信号转导和转录激活剂抑制剂,最常见的是与甲氨蝶呤(MTX)联合使用:研究旨在比较生物逻辑疾病修饰抗风湿药(bDMARDs)和靶向合成(ts)DMARDs治疗的有效性和副作用:分析对象包括108名患有活动性疾病的RA患者,他们每周接受25毫克MTX治疗。80名患者(I组)接受了bDMARDs治疗,28名患者(II组)接受了JAK-STAT抑制剂治疗。对晨僵持续时间、视觉模拟量表(VAS)显示的疼痛、28关节疾病活动度评分(DAS28)和简化疾病活动度评分(SDAI)进行了评估。采用 Larsen 和 Dale 标准对患者手脚的经典放射影像进行了评估。分析了使用bDMARDs和tsDMARDs治疗的效果:结果:所有研究对象都至少达到了拉森和戴尔标准的第 3 阶段,出现了典型的 RA X 射线变化。研究组之间在病程、血沉、CRP、DAS28 和 SDAI 值方面没有明显的统计学差异。II 组患者之前使用的 bDMARDs 药物数量高于接受 bDMARDs 治疗的 I 组患者。所有患者在治疗后均有较低的疾病活动度;因此,II 组患者(使用 tsDMARDs 治疗)在 VAS 上获得的患者总体评估值较低:本观察性研究的结果表明,JAK 抑制剂的治疗前景非常广阔。结论:本观察性研究结果表明,JAK 抑制剂的治疗前景非常广阔,其疗效并不比 bDMARDs 差。在JAK治疗前和治疗期间监测患者血栓栓塞事件非常重要。
Comparison of treatment of severe rheumatoid arthritis patients with biological agents and JAK-STAT inhibitors. An observational study.
Introduction: Treatment of severe rheumatoid arthritis (RA) is currently based either on biological agents or Janus kinase/signal transducer and activator of transcription inhibitors, most often in combination with methotrexate (MTX).
Aim of the study: The aim of the study was to compare the effectiveness and side effects of bio- logic disease-modifying antirheumatic drugs (bDMARDs) and targeted synthetic (ts) DMARDs treatment.
Material and methods: The analysis included 108 RA patients with active disease treated with MTX 25 mg per week. Eighty patients (group I) were treated with bDMARDs and 28 patients (group II) with JAK-STAT inhibitors. The duration of morning stiffness, pain on Visual Analogue Scale (VAS), 28-joints Disease Activity Score (DAS28) and Simplified Disease Activity Score (SDAI) were assessed. Classical radiographic images of patients' hands and feet using the Larsen and Dale's criteria were evaluated. The effects of treatment with bDMARDs and tsDMARDs were analyzed.
Results: All studied patients presented at least Larsen and Dale's stage 3 of X-ray changes typical for RA. There were no statistically significant differences in disease duration, ESR, CRP, DAS28 and SDAI values between studied groups. Patients from group II previously used higher numbers of bDMARDs than group I treated with bDMARDs. Low disease activity after treatment was achieved by all patients; therefore patients from group II (treated with tsDMARDs) achieved lower values of patients' global assessment on VAS.
Conclusions: The results of the present observational study indicated that treatment with JAK inhibitors is very promising. These drugs are not inferior in effectiveness to bDMARDs. It is important to monitor patients for thromboembolic events before and during JAK treatment.