托法替布治疗中重度类风湿关节炎的疗效及安全性分析  

Efficacy and safety analysis of tofacitinib in the treatment of moderate and severe rheumatoid arthritis

作　　者：高乐女[1] 钟兵[1] 陈雪猛 陈珏蓉 宋福学[1] 邹庆华[1] 李景怡[1] 方勇飞[1] 王勇[1] GAO Lenyu;ZHONG Bing;CHEN Xuemeng(Department of Rheumatology, Southwest Hospital of Army Military Medical University (Third Military Medical University), Chongqing 400038 , China)

机构地区：[1]陆军军医大学(第三军医大学)西南医院中医与风湿免疫科,重庆市400038

出　　处：《临床合理用药杂志》2019年第13期29-31,共3页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的分析Janus激酶(JAK)抑制剂托法替布治疗中重度类风湿关节炎(RA)的疗效和安全性。方法选取2017年8月-2018年4月医院经传统改善病情抗风湿药(DMARDs)或联合生物制剂治疗效果均不佳的中重度RA患者21例,进行托法替布联合甲氨蝶呤治疗。入组前及服药第1、2、3月后分别评估28个关节疾病活动评分DAS28、红细胞沉降率(ESR)、C反应蛋白(CRP)、关节肿胀及压痛数、血常规及肝肾功能等。结果 20例患者的DAS28(4)、ESR均较治疗前显著下降,关节肿胀及压痛数亦较治疗前显著减少,差异有统计学意义(P<0.05),1例患者无效。所有患者在接受托法替布治疗前后均未发生过敏反应,血常规肝肾功无异常变化,亦无其他严重不良反应。结论托法替布联合甲氨蝶呤治疗RA安全性高,能在一定程度上改善部分传统DMARDs或联合生物制剂治疗效果不佳的中重度RA患者的病情。Objective To investigate the efficacy and safety of Janus kinase(JAK) inhibitor tofacitinib combined with methotrexate in the treatment of moderate to severe rheumatoid arthritis(RA).Methods 21 case of moderate to severe RA patients inadequate response to disease-modifying anti-rheumatic drugs(DMARDs) or combined with biologics in the hospital from August 2017 to April 2018 were selected,they were underwent tofacitinib combined with methotrexate.The 28 joint disease activity scores(DAS28),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),joint swelling and tenderness,blood routine and liver and kidney function were evaluated before enrollment and after 1,2,and 3 months.Results The DAS28(4) and erythrocyte sedimentation rate of 20 patients were significantly lower than before treatment,the number of joint swelling and tenderness was also significantly lower than before treatment,the difference was statistically significant(P<0.05),but ineffective in another one patient.All patients had no allergic reaction before and after treatment with tofacitinib.There was no abnormal change in blood routine liver and kidney function,and there were no other serious adverse reactions.Conclusion Tofacitinib combined with methotrexate is safe for the treatment of RA,and can improve some RA patients with inadequate response to some traditional DMARDs or combined biologics.

关 键 词：类风湿关节炎 托法替布 疗效 安全性 

分 类 号：R593.22[医药卫生—内科学]