托法替布或艾拉莫德联合甲氨蝶呤治疗活动性类风湿性关节炎的疗效研究  

Efficacy of Tofacitinib or Iguratimod Combined with Methotrexate in the Treatment of Active Rheumatoid Arthritis

作　　者：周春仁 周洋来 李颖 陈淑红 杨林霏 ZHOU Chunren;ZHOU Yanglai;LI Ying;CHEN Shuhong;YANG Linfei(Fuzhou Municipal Hospital,Fuzhou Jiangxi 344000,China;Linchuan District People's Hospital,Fuzhou Jiangxi 344000,China)

机构地区：[1]抚州市立医院,江西抚州344000 [2]临川区人民医院,江西抚州344000

出　　处：《药品评价》2023年第3期338-341,共4页Drug Evaluation

基　　金：抚州市指导性科技计划项目[抚科社字〔2022〕5号-48]。

摘　　要：目的探讨活动性类风湿性关节炎采用托法替布或艾拉莫德联合甲氨蝶呤治疗的临床效果。方法研究对象为2021年6月至2022年5月抚州市立医院收治的90例活动性类风湿关节炎患者,使用随机数字表法分为对照组、托法替布组和艾拉莫德组,每组30例,对照组采用甲氨蝶呤治疗,托法替布组采用托法替布联合甲氨蝶呤治疗,艾拉莫德组采用艾拉莫德联合甲氨蝶呤治疗,对比三组的临床疗效和安全性。结果托法替布组和艾拉莫德组的ACR20/50/70缓解率均较对照组高(P<0.05);托法替布组和艾拉莫德组的ACR20/50/70缓解率均差异无统计学意义(P>0.05)。托法替布组和艾拉莫德组治疗3个月和6个月后的血沉(ESR)、C反应蛋白(CRP)均较对照组低(P<0.05),且均较治疗前降低(P<0.05),但两组均差异无统计学意义(P>0.05)。托法替布组和艾拉莫德组治疗3个月和6个月后的基于ESR的28个关节疾病活动评分(DAS28-ESR)较对照组高(P<0.05),且均较治疗前增加(P<0.05),但两组均差异无统计学意义(P>0.05)。三组的不良反应发生率均差异无统计学意义(P>0.05)。结论在活动性类风湿性关节炎的治疗中,托法替布联合甲氨蝶呤和艾拉莫德联合甲氨蝶呤治疗的效果显著,可以减轻炎症反应,提高关节活动性,且安全性良好。Objective To investigate the clinical effect of tofacitinib or iguratimod combined with methotrexate in the treatment of active rheumatoid arthritis.Methods The research object were 90 patients with active rheumatoid arthritis treated in Fuzhou Municipal Hospital from June 2021 to May 2022,these patients were divided into control group,tofacitinib group and iguratimod group by random number table method,with 30 cases in each group.The control group was treated with methotrexate,the tofacitinib group was treated with tofacitinib combined with methotrexate,and the iguratimod group was treated with iguratimod combined with methotrexate.The clinical efficacy and safety of the three groups were compared.Results The ACR20/50/70 response rate of tofacitinib group and iguratimod group were higher than those of control group(P<0.05).There were no significant differences in the response rates of ACR20/50/70 between tofacitinib group and iguratimod group(P>0.05).After 3 months and 6 months of treatment,the ESR and C-reactive protein(CRP)of the tofacitinib group and the iguratimod group were lower than those of the control group(P<0.05)and decreased compared with before treatment(P<0.05),with no significant differences between the two groups(P>0.05).The ESR-based disease activity score of 28 joints(DAS28-ESR)after 3 and 6 months of treatment was higher in the tofacitinib and iguratimod groups than in the control group(P<0.05)and increased compared with that before treatment(P<0.05),with no significant difference between the two groups(P>0.05).There was no significant difference in the incidence of adverse reactions among the three groups(P>0.05).Conclusions In the treatment of active rheumatoid arthritis,tofacitinib combined with methotrexate or iguratimod combined with methotrexate have more significant effects,which can reduce inflammation and improve joint mobility with good safety.

关 键 词：关节炎 类风湿 托法替布 艾拉莫德 甲氨蝶呤 

分 类 号：R593.22[医药卫生—内科学]