巴瑞替尼联合艾拉莫德治疗难治性类风湿关节炎的疗效  

Efficacy of baricitinib combined with iguratimod in the treatment of refractory rheumatoid arthritis

作　　者：陈建明 雷美红[1] 张兰霞 CHEN Jianming;LEI Meihong;ZHANG Lanxia(Department of Rheumatology,The 909th Hospital of Joint Logistic Support Force,Affiliated Southeast Hospital of Xiamen University,Zhangzhou,Fujian 363000,China)

机构地区：[1]联勤保障部队第九〇九医院、厦门大学附属东南医院风湿科,福建漳州363000

出　　处：《中国临床研究》2023年第11期1678-1682,共5页Chinese Journal of Clinical Research

摘　　要：目的探讨巴瑞替尼联合艾拉莫德治疗难治性类风湿关节炎(RRA)的疗效和安全性。方法选取2021年8月至2022年12月在厦门大学附属东南医院收治的RRA患者15例,给予艾拉莫德(25 mg,bid)联合巴瑞替尼(4 mg,qd)治疗24周,观察治疗12周及24周后肿胀关节数(SJC)、压痛关节数(TJC)、超敏C反应蛋白(hs-CRP)、28个关节C反应蛋白的疾病活动评分(DAS28-CRP)的变化以及不良反应情况。结果15例RRA患者的病情都得到不同程度的缓解。与治疗前相比,治疗12周、治疗24周,TJC和SJC减少,hs-CRP水平和DAS28-CRP评分降低,差异有统计学意义(P<0.05)。经过24周的治疗,有3例达到病情缓解(DAS28-CRP≤2.6分),6例达到低活动度(2.6分<DAS28-CRP<3.2分),达标率为60.0%(9/15)。且所有患者都耐受性良好,未出现带状疱疹、血栓事件、肝肾功能损害等不良反应。结论巴瑞替尼联合艾拉莫德治疗RRA临床疗效显著,安全性良好。Objective To investigate the efficacy and safety of baricitinib in combination with iguratimod in the treatment of refractory rheumatoid arthritis(RRA).Methods Fifteen RRA patients admitted to Affiliated Southeast Hospital of Xiamen University from August 2021 to December 2022 were selected and treated with iguratimod(25 mg,bid)combined with baricitinib(4 mg,qd)for 24 weeks.The changes in swelling joint count(SJC),tenderness joint count(TJC),hypersensitive C-reactive protein(hs-CRP),Disease Activity Score using 28 joint counts(DAS28)CRP,and adverse reactions were observed after 12 and 24 weeks of treatment.Results All 15 patients with RRA had different degrees of remission.Compared with before treatment,TJC and SJC decreased,while hs-CRP levels and DAS28-CRP decreased after 12 weeks and 24 weeks of treatment(P<0.05).After 24 weeks of treatment,3 cases achieved clinical remission(DAS28-CRP≤2.6),and 6 cases achieved low disease activity(2.6<DAS28-CRP≤3.2),with a compliance rate of 60.0%(9/15).All patients had good tolerance,without any adverse reactions such as herpes zoster,thrombotic events,liver and kidney damage.Conclusion Baricitinib combined with iguratimod is highly effective and safety in treating patients with RRA.

关 键 词：巴瑞替尼 艾拉莫德 类风湿关节炎 难治性 肿胀关节数 压痛关节数 超敏C反应蛋白 28个关节疾病活动度评分 

分 类 号：R593.22[医药卫生—内科学]