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Arthritis Res Ther：塔西单抗单药治疗可以作为类风湿关节炎的二线治疗

2016-09-29 Moon 译 MedSci原创

塔西单抗类风湿关节炎联合治疗
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最近公布的调查结果显示：对于类风湿关节炎患者，塔西单抗单药治疗 vs 塔西单抗+常规合成的可改变病情的抗风湿药物联合治疗，疗效相似。 对于常规合成DMARDs (csDMARDs) 治疗失败的类风湿关节炎患者，可以选择塔西单抗(Actemra, Genentech)作为二线治疗。既往的研究也表明，塔西单抗单药治疗这类患者是有效的，但是塔西单抗+csDMARDs联合治疗的疗效又如何呢？

最近公布的调查结果显示：对于类风湿关节炎患者，塔西单抗单药治疗 vs 塔西单抗+常规合成的可改变病情的抗风湿药物联合治疗，疗效相似。

对于常规合成DMARDs (csDMARDs) 治疗失败的类风湿关节炎患者，可以选择塔西单抗(Actemra, Genentech)作为二线治疗。既往的研究也表明，塔西单抗单药治疗这类患者是有效的，但是塔西单抗+csDMARDs联合治疗的疗效又如何呢？

为了探究这个问题，研究者对13项随机临床试验进行了荟萃分析，涉及6679名患者。研究者收集了DAS28、ACR20、ACR50、ACR70和不良事件等信息。通过随机效应模型对合并后的相对风险和置信空间进行了评估，此外，研究者还进行了敏感性分析，评估研究时间的差异。

数据显示，联合治疗组达到DAS28（RR = 1.21）和ACR50（RR = 1.14）的患者比例稍微更大些；但是联合治疗组的不良反应事件发生率也更高（RR = 1.40）。

研究人员得出结论，不管是塔西单抗单药治疗还是结合csDMARDs联合治疗，疗效相似，但是，联合治疗会增加不良事件的风险。

研究者称，对于不耐受csDMARDs的类风湿关节炎患者，塔西单抗单药治疗是不错的选择。

原始出处：

Teitsma XM, et al. Tocilizumab as monotherapy or combination therapy for treating active rheumatoid arthritis: a meta-analysis of efficacy and safety reported in randomized controlled trials.Arthritis Res Ther. 2016;doi:10.1186/s13075-016-1108-9.

Similar efficacy seen between tocilizumab as monotherapy vs combination therapy.Healio.9.September 28, 2016

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    2017-02-03 12498717m75(暂无昵称)

    #单药治疗#

    0

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    2016-10-27 ms6390871039024434

    #Arthritis#

    0

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    2016-10-11 1e10c84am36(暂无匿称)

    好文章，受益

    0

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    2016-10-01 lmm397

    #关节炎#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1687690, encodeId=ef30168e690fc, content=<a href='/topic/show?id=be223633375' target=_blank style='color:#2F92EE;'>#单药治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36333, encryptionId=be223633375, topicName=单药治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2bef28414326, createdName=12498717m75(暂无昵称), createdTime=Fri Feb 03 11:12:00 CST 2017, time=2017-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1972359, encodeId=bfa519e235916, content=<a href='/topic/show?id=8a6a2e8839' target=_blank style='color:#2F92EE;'>#Arthritis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2788, encryptionId=8a6a2e8839, topicName=Arthritis)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIibticIBly5jCSic5ZElW4He3rO4DMpUHUFaFX57OicNMnzckWaicBNeStwugWHFCuOdicoakApM4HGmtw/132, createdBy=f8672500006, createdName=ms6390871039024434, createdTime=Thu Oct 27 02:12:00 CST 2016, time=2016-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145923, encodeId=cf9e14592313, content=好文章，受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Oct 11 22:26:21 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1265345, encodeId=0b081265345df, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Sat Oct 01 10:12:00 CST 2016, time=2016-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1333829, encodeId=271f133382948, content=<a href='/topic/show?id=5306e6164b6' target=_blank style='color:#2F92EE;'>#类风湿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76164, encryptionId=5306e6164b6, topicName=类风湿)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq2AGzrugK9ZUjU3eJxzM901ophWib0xJDrSicy49ibWl3zB5pbDto7eoR6tnzwOiaKdbq1a8PcbYFFrw/132, createdBy=6ff22500098, createdName=ms4964546379600229, createdTime=Sat Oct 01 10:12:00 CST 2016, time=2016-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356114, encodeId=f1ed135611448, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Oct 01 10:12:00 CST 2016, time=2016-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1543906, encodeId=02a01543906f9, content=<a href='/topic/show?id=02982402298' target=_blank style='color:#2F92EE;'>#二线治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24022, encryptionId=02982402298, topicName=二线治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=520213623738, createdName=ms5768352621950538, createdTime=Sat Oct 01 10:12:00 CST 2016, time=2016-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1597256, encodeId=af88159e25642, content=<a href='/topic/show?id=fa1710082017' target=_blank style='color:#2F92EE;'>#风湿关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100820, encryptionId=fa1710082017, topicName=风湿关节炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=456818510265, createdName=xuruicheng, createdTime=Sat Oct 01 10:12:00 CST 2016, time=2016-10-01, status=1, ipAttribution=)]
    2016-10-01 ms4964546379600229

    #类风湿#

    0

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    2016-10-01 zhaojie88

    #ART#

    0

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    2016-10-01 ms5768352621950538

    #二线治疗#

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1687690, encodeId=ef30168e690fc, content=<a href='/topic/show?id=be223633375' target=_blank style='color:#2F92EE;'>#单药治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36333, encryptionId=be223633375, topicName=单药治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2bef28414326, createdName=12498717m75(暂无昵称), createdTime=Fri Feb 03 11:12:00 CST 2017, time=2017-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1972359, encodeId=bfa519e235916, content=<a href='/topic/show?id=8a6a2e8839' target=_blank style='color:#2F92EE;'>#Arthritis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2788, encryptionId=8a6a2e8839, topicName=Arthritis)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIibticIBly5jCSic5ZElW4He3rO4DMpUHUFaFX57OicNMnzckWaicBNeStwugWHFCuOdicoakApM4HGmtw/132, createdBy=f8672500006, createdName=ms6390871039024434, createdTime=Thu Oct 27 02:12:00 CST 2016, time=2016-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145923, encodeId=cf9e14592313, content=好文章，受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Oct 11 22:26:21 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1265345, encodeId=0b081265345df, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Sat Oct 01 10:12:00 CST 2016, time=2016-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1333829, encodeId=271f133382948, content=<a href='/topic/show?id=5306e6164b6' target=_blank style='color:#2F92EE;'>#类风湿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76164, encryptionId=5306e6164b6, topicName=类风湿)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq2AGzrugK9ZUjU3eJxzM901ophWib0xJDrSicy49ibWl3zB5pbDto7eoR6tnzwOiaKdbq1a8PcbYFFrw/132, createdBy=6ff22500098, createdName=ms4964546379600229, createdTime=Sat Oct 01 10:12:00 CST 2016, time=2016-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356114, encodeId=f1ed135611448, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Oct 01 10:12:00 CST 2016, time=2016-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1543906, encodeId=02a01543906f9, content=<a href='/topic/show?id=02982402298' target=_blank style='color:#2F92EE;'>#二线治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24022, encryptionId=02982402298, topicName=二线治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=520213623738, createdName=ms5768352621950538, createdTime=Sat Oct 01 10:12:00 CST 2016, time=2016-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1597256, encodeId=af88159e25642, content=<a href='/topic/show?id=fa1710082017' target=_blank style='color:#2F92EE;'>#风湿关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100820, encryptionId=fa1710082017, topicName=风湿关节炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=456818510265, createdName=xuruicheng, createdTime=Sat Oct 01 10:12:00 CST 2016, time=2016-10-01, status=1, ipAttribution=)]
    2016-10-01 xuruicheng

    #风湿关节炎#

    0