Arthritis Rheumatol:依那西普和甲氨蝶呤单药或联合用药治疗银屑病关节炎的疗效

2019-02-20 xiangting MedSci原创

联合甲氨蝶呤和依那西普并未改善依那西普的疗效。

这项研究旨在比较甲氨蝶呤和依那西普单药治疗银屑病关节炎(PsA)的疗效,以及甲氨蝶呤和依那西普联合用药的价值。

在这项双盲研究中,851名PsA患者被随机分为:口服甲氨蝶呤20mg加安慰剂组,每周1次(N=284);依那西普50mg加安慰剂组,每周1次(N=284);或依那西普50mg加口服甲氨蝶呤20mg每周1次组(联合治疗; N=283)。第24周的美国风湿病学会(ACR)20应答率和最小疾病活动度(MDA)应答分别是主要和次要终点。还评估了炎性关节炎、影像学进展和非关节疾病表现的其他指标。

平均(标准差[SD])年龄为48.4(13.1)岁; 平均PsA病程为3.2年(SD:6.3;中位数:0.6)。第24周依那西普单药治疗ACR20和MDA应答显著高于甲氨蝶呤单药治疗(ACR20:60.9%vs 50.7%[P=0.029]; MDA:35.9%vs 22.9%[P=0.005]),联合治疗显著高于甲氨蝶呤单药治疗(ACR20:65.0%vs 50.7%[P=0.005];MDA:35.7%vs 22.9%[P=0.005])。其他次要结局(ACR50、ACR70、极低疾病活动性评分和银屑病关节炎疾病活动性评分)与这些结果一致。与甲氨蝶呤单药治疗相比,第48周使用依那西普组的影像学进展较少。除了一些皮肤方面的终点外,联合治疗和依那西普单药治疗的结果相似。没有发现新的安全性信号。

依那西普单药和联合治疗比甲氨蝶呤单药治疗在ACR和MDA应答及影像学进展方面表现出更大的疗效。总体而言,联合甲氨蝶呤和依那西普并未改善依那西普的疗效。

原始出处:

Philip J. Mease. Etanercept and Methotrexate as Monotherapy or in Combination for Psoriatic Arthritis: Primary Results From a Randomized, Controlled Phase 3 Trial. Arthritis Rheumatol. 12 February 2019.

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    2019-02-22 lmm397
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    2019-02-22 zhaojie88
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    2019-02-20 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0

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