METHODS: Patients with PMR which could be classified as RA and who were treated with bDMARDs were included in the analysis. The primary endpoint was the clinical Polymyalgia Rheumatica Activity Score (Clin-PMR-AS) after 26 weeks of treatment, and the secondary endpoint was adverse events during the observation period.
RESULTS: A total of 203 patients with PMR which was resistant or intolerant to glucocorticoids and could be classified as RA were receiving bDMARDs and were enrolled in the study. There were 83, 82, and 38 patients in the tumor necrosis factor inhibitor (TNFi), interleukin-6 receptor inhibitor (IL-6Ri), and cytotoxic T lymphocyte-associated antigen-4-immunoglobulin (CTLA4-Ig) groups, respectively. Twenty-six weeks after bDMARD initiation, Clin-PMR-AS levels were significantly lower in the IL-6Ri group as compared to other groups. Multiple regression analysis was performed with Clin-PMR-AS as the objective variable. Body mass index (BMI), history of bDMARDs, and IL-6Ri use were identified as factors involved in Clin-PMR-AS. After adjustment for group characteristics using inverse probability of treatment weighting with propensity scores, the Clin-PMR-AS score at 26 weeks was significantly lower in the IL-6Ri group (9.0) than in both the TNFi (12.4, p = 0.004) and CTLA4-Ig (15.9, p = 0.003) group.
CONCLUSIONS: IL-6Ri may potentially improve the disease activity of PMR compared to other bDMARDs.
方法:将PMR患者纳入分析,这些患者可以归类为RA,并接受bDMARDs治疗。主要终点是治疗26周后的临床多肌痛风湿性活动评分(Clin-PMR-AS),次要终点为观察期间的不良事件.
结果:共有203名PMR患者接受bDMARDs治疗,这些患者对糖皮质激素耐药或不耐受,可归类为RA。肿瘤坏死因子抑制剂(TNFi)有83、82和38例患者,白细胞介素-6受体抑制剂(IL-6Ri),和细胞毒性T淋巴细胞相关抗原-4-免疫球蛋白(CTLA4-Ig)组,分别。bDMARD启动后26周,与其他组相比,IL-6Ri组的Clin-PMR-AS水平显着降低。以Clin-PMR-AS为客观变量进行多元回归分析。身体质量指数(BMI),BDMARDs的历史,和IL-6Ri的使用被确定为参与Clin-PMR-AS的因素。在使用倾向评分的治疗加权逆概率调整组特征后,IL-6Ri组(9.0)26周时的Clin-PMR-AS评分显著低于TNFi组(12.4,p=0.004)和CTLA4-Ig组(15.9,p=0.003).
结论:与其他bDMARD相比,IL-6Ri可能潜在地改善PMR的疾病活动性。