托法替布与艾拉莫德联合甲氨蝶呤治疗活动性类风湿性关节炎的效果  

Effect of Tofacitinib and Iguratimod in Combination with Methotrexate in the Treatment of Active Rheumatoid Arthritis

作　　者：周春仁 周洋来 李颖 陈淑红 ZHOU Chunren;ZHOU Yangai;LI Ying;CHEN Shuhong(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]抚州市临川区人民医院,江西抚州344000

出　　处：《药品评价》2024年第3期297-300,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 研究托法替布、艾拉莫德分别与甲氨蝶呤联用对活动性类风湿性关节炎(RA)的治疗效果及安全性。方法 选择2021年3月至2023年5月期间抚州市立医院收治的活动性RA患者90例,随机分为对照组、托法替布组、艾拉莫德组,每组各30例患者。对照组用甲氨蝶呤单独治疗,托法替布组在对照组基础上加服托法替布,艾拉莫德组在对照组基础上加服艾拉莫德,比较三组的治疗效果及安全性。结果 托法替布组和艾拉莫德组的ACR20/50/70缓解率均高于对照组(P<0.05),但托法替布组和艾拉莫德组组间比较差异无统计学意义(P>0.05)。托法替布组和艾拉莫德组第3个月、第6个月血沉、C反应蛋白的指标均较对照组低,且低于本组治疗前(P<0.05);托法替布组和艾拉莫德组的晨僵时间均短于对照组(P<0.05),托法替布组和艾拉莫德组的晨僵时间差异无统计学意义(P>0.05)。三组的不良反应发生率比较,差异无统计学意义(P>0.05)。结论 托法替布与甲氨蝶呤、艾拉莫德与甲氨蝶呤联用治疗活动性RA均可有效缓解临床症状,减轻炎症反应,缩短其晨僵时间,具有良好的治疗效果,且安全性高。Objective To study the efficacy and safety of tofacitinib and iguratimod combined with methotrexate in the treatment of active rheumatoid arthritis(RA).Methods A total of 90 patients with active RA admitted to Fuzhou Municipal Hospital from March 2021 to May 2023 were randomly divided into control group,tofacitinib group and iguratimod group,with 30 patients in each group.The control group was treated with methotrexate alone,the tofacitinib group was additionally treated with tofacitinib,and the iguratimod group was additionally treated with iguratimod.The therapeutic effect and safety of the three groups were compared.Results The response rates of ACR20/50/70 in tofacitinib group and iguratimod group were higher than those in control group(P<0.05),but there was no statistical significance between tofacitinib group and iguratimod group(P>0.05).Erythrocyte sedimentation rate and C-reactive protein in tofacitinib group and iguratimod group at the 3rd and 6th month were lower than those in control group,and lower than those before treatment(P<0.05);the morning stiffness time of tofacitinib group and iguratimod group was shorter than that of control group(P<0.05),but there was no significant difference in morning stiffness time between tofacitinib group and iguratimod group(P>0.05).There was no significant difference in the incidence of adverse reactions among the three groups(P>0.05).Conclusion Tofacitinib combined with methotrexate and iguratimod combined with methotrexate in the treatment of active RA can effectively relieve clinical symptoms,reduce inflammation and shorten the morning stiffness time,with good therapeutic effect and high safety.

关 键 词：托法替布 艾拉莫德 甲氨蝶呤 类风湿性关节炎 

分 类 号：R593.22[医药卫生—内科学]