背景:对于慢性疾病,如轴性脊柱关节炎(axSpA),银屑病关节炎(PsA),和斑块状银屑病(PsO),治疗目标包括12周前缓解或至少降低疾病活动度(LDA)。改善疼痛和疲劳等症状也应成为治疗目标。
方法:ADEQUATE是德国人,prospective,非干预性研究评估类风湿关节炎患者的比例,PsA,axSpA,或者是谁,在常规临床实践中,继续使用依那西普(ETN)治疗超过12周,即使他们的治疗目标尚未达到。还记录了患者报告的结果(PRO)和伴随糖皮质激素使用的变化。本文重点介绍axSpA和PsA患者的结果;简要介绍了PsO患者的数据。
结果:总计,305、254和70名axSpA患者,PsA,和PsO,分别,包括在内。第12周和第24周的缓解率axSpA分别为19%和18%,38%和51%的PSA,PsO分别为7%和19%。分别在第12周和第24周的LDA率,axSpA分别为39%和45%,50%和60%的PSA,PsO分别为34%和51%。将治疗延长至52周与缓解率和LDA率的稳定或进一步增加相关。改善疼痛,疲劳,和抑郁症(axSpA,PsA,和PsO)以及同时使用糖皮质激素(axSpA和PsA)的减少。没有检测到新的安全信号。
结论:这些发现证实了ETN在多种适应症的常规临床实践中的有效性和安全性,并强调了在12周后未达到治疗目标的患者中继续ETN治疗的潜在益处。其他益处包括PRO的改善和伴随的糖皮质激素的减少。
背景:ClinicalTrials.govNCT02486302。
轴性脊柱关节炎是一种主要在脊柱引起关节疼痛并可引起脊柱变形的疾病。银屑病关节炎和斑块状银屑病是导致干燥的疾病,发痒,和凸起的皮肤补丁。银屑病关节炎也会引起肿胀,僵硬,关节疼痛。Etanercept是一种用于减轻轴向脊柱关节炎症状的治疗方法,银屑病关节炎,和斑块状牛皮癣。治疗的目的是缓解,或12周后疾病活动低。在这项研究中,人们从德国的普通医生那里接受了长达52周的etanercept。共有305人患有轴性脊柱关节炎,254名银屑病关节炎患者,70名斑块状银屑病患者参加了这项研究。治疗12周后,100例中轴型脊柱关节炎患者中有19例缓解,100例中39例疾病活动性低。此外,100名银屑病关节炎患者中有38名缓解,100名患者中有50名疾病活动性低。最后,100例斑块型银屑病患者中有7例缓解,100例中有34例疾病活动性低。这些数字在研究结束之前基本保持稳定。人们也报告疼痛较少,疲劳,和抑郁症。大多数人能够使用较少的糖皮质激素。不需要的副作用的数量和类型与其他研究中发现的那些在轴向脊柱关节炎患者中的依那西普相似,银屑病关节炎,或斑块状牛皮癣。
BACKGROUND: For chronic diseases such as axial spondyloarthritis (axSpA), psoriatic arthritis (PsA), and plaque psoriasis (PsO), treatment goals include remission or at least low disease activity (LDA) by 12 weeks. Improvements in symptoms such as pain and fatigue should also be treatment goals.
METHODS: ADEQUATE was a German, prospective, non-interventional
study to evaluate the proportion of patients with rheumatoid arthritis, PsA, axSpA, or PsO who, in routine clinical practice, benefit from the continuation of treatment with etanercept (ETN) beyond 12 weeks, even when their treatment goals have not yet been reached. Patient-reported outcomes (PROs) and changes in concomitant glucocorticoid use were also recorded. This article focuses on results for patients with axSpA and PsA; data for patients with PsO are described briefly.
RESULTS: In total, 305, 254, and 70 patients with axSpA, PsA, and PsO, respectively, were included. Rates of remission at week 12 and week 24, respectively, were 19% and 18% for axSpA, 38% and 51% for PsA, and 7% and 19% for PsO. Rates of LDA at week 12 and week 24, respectively, were 39% and 45% for axSpA, 50% and 60% for PsA, and 34% and 51% for PsO. Extending treatment up to 52 weeks was associated with stable rates of or further increases in remission and LDA rates. Improvements in pain, fatigue, and depression (axSpA, PsA, and PsO) and reductions in concomitant glucocorticoid use (axSpA and PsA) were observed. No new safety signals were detected.
CONCLUSIONS: These findings confirm the effectiveness and safety of ETN in routine clinical practice for several indications and highlight potential benefits of continuing ETN treatment in patients who have not reached their treatment goals after 12 weeks. Additional benefits included improvements in PROs and reduction of concomitant glucocorticoids.
BACKGROUND: ClinicalTrials.gov NCT02486302.
Axial spondyloarthritis is a disorder that causes joint pain mainly in the spine and can cause deformation of the spine. Psoriatic arthritis and plaque psoriasis are disorders that cause dry, itchy, and raised skin patches. Psoriatic arthritis also causes swollen, stiff, and painful joints. Etanercept is a treatment used to reduce the symptoms of axial spondyloarthritis, psoriatic arthritis, and plaque psoriasis. The aim of treatment is remission, or low disease activity after 12 weeks. In this
study, people received etanercept for up to 52 weeks from their usual doctors in Germany. A total of 305 people with axial spondyloarthritis, 254 people with psoriatic arthritis, and 70 people with plaque psoriasis took part in the
study. After 12 weeks of treatment, 19 in 100 people with axial spondyloarthritis were in remission and 39 in 100 people had low disease activity. In addition, 38 in 100 people with psoriatic arthritis were in remission and 50 in 100 people had low disease activity. Finally, 7 in 100 people with plaque psoriasis were in remission and 34 in 100 people had low disease activity. These numbers remained mostly stable until the end of the
study. People also reported less pain, fatigue, and depression. Most people were able to use less glucocorticoids. The number and types of unwanted side effects were similar to those seen in other studies of etanercept in people with axial spondyloarthritis, psoriatic arthritis, or plaque psoriasis.