生物制剂对银屑病关节炎中轴表现的疗效：对依那西普治疗的一组患者为期12个月的观察性研究

原文

译文

Clin Exp Rheumatol. 2011 Jan-Feb;29(1):80-4. Epub 2011 Feb 23. The effectiveness of a biologic agent on axial manifestations of psoriatic arthritis. A twelve months observational study in a group of patients treated with etanercept. Lubrano E, Spadaro A, Marchesoni A, Olivieri I, Scarpa R, D'Angelo S, Salvarani C, Mathieu A, Cauli A, Ferrara N, Helliwell P. Department of Health Sciences, School of Medicine, University of Molise, Campobasso, Italy. enniolubrano@hotmail.com. Abstract OBJECTIVES: To investigate the effectiveness of etanercept on axial manifestations of a group of patients with established psoriatic arthritis (PsA). METHODS: This was a multicentre observational study. PsA was classified based on the CASPAR criteria. Inclusion criteria were refractory PsA with axial manifestations and suitability for anti TNF-α therapy. Effectiveness was defined according to the ASAS response criteria (BASDAI: 50% relative or absolute change of 20mm and expert opinion in favour of continuation), and on the improvements of BASFI, anthropometric measures, PASI, ESR and CRP at 12 months. PASI 50 and 75 were also assessed, as well as the ACR20 and ACR50 response criteria for patients with peripheral arthritis. Comparisons between baseline and after 12-month treatment were done using the Wilcoxon signed rank test for the end-points considered. RESULTS: The study included 32 patients (25/7 M/F; median age 51yrs; 25th-75th percentiles: 34.5-58.7; median disease duration 14.5 yrs; 25th-75th percentiles: 9.2-17.00). Effectiveness of etanercept was observed in 72% of patients for the BASDAI (p<0.001), in 68% for the BASFI (p<0.001), in 76% for ESR (p<0.001) and in 68% of patients for CRP (p<0.01). The PASI improved in 72% of patients treated (p<0.0001), while PASI 50 and PASI 75 was reached in 81% and 55% of patients, respectively. ACR 20 and 50 was reached in 78 and 56% of patients with peripheral involvement respectively. CONCLUSIONS: The present study has shown that etanercept is effective on axial manifestations of established PsA, confirming the positive effects of anti TNF-α therapy on clinical manifestations of the disease.

生物制剂对银屑病关节炎中轴表现的疗效：对依那西普治疗的一组患者为期12个月的观察性研究   目的：探讨依那西普对确诊的银屑病关节炎(PsA)患者中轴关节表现的疗效。 方法:本研究是多中心观察性研究。PsA诊断符合CASPAP分类标准。入选标准为有中轴关节表现的复发性PsA并适合应用抗TNF-α治疗。疗效评价根据ASAS反应标准（BASDAI:50%相对值或20mm绝对值改善和专家的意见认为可以继续),以及12个月时BASFI、人体测量数据、PASI、ESR和CRP的改善。对PASI 50和 75也进行了评估,对有外周关节炎表现的患者还依据ACR20和ACR50反应标准作出评价。应用Wilcoxon符号秩次检验法比较观察终点在基线水平及治疗12个月后的变化。   结果:本研究包括了32例患者(男女比为25/7，平均年龄51岁;25 -75百分位数： 34.5-58.7；平均病程14.5年，25 -75百分位数：9.2-17.00)。依那西普的疗效观察为BASDAI 72% (p < 0.001), BASFI 68% (p < 0.001), ESR 76% (p < 0.001) CRP68% (p < 0.01)。72%患者的PASI得到改善 (p < 0.0001),而PASI 50和PASI75分别高达81%和55%。ACR20和50对外周关节炎患者有效率分别为78%和56%。     结论:目前研究显示,依那西普治疗确诊的PsA患者中轴关节表现有效,证实了抗TNF-α治疗对该疾病临床表现的有效性。