类风湿关节炎患者使用乌达帕替尼治疗的实际效果和疗效：来自 CorEvitas 登记处的分析。

IF 2.9 3区医学 Q2 RHEUMATOLOGY Rheumatology and Therapy Pub Date : 2024-04-01 Epub Date: 2024-02-12 DOI:10.1007/s40744-024-00639-4

Joshua F Baker, Patrick Zueger, Mira Ali, Denise Bennett, Miao Yu, Yolanda Munoz Maldonado, Robert R McLean

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引用次数: 0

摘要

简介：目前尚缺乏对类风湿性关节炎（RA）患者使用 Janus 激酶抑制剂乌达替尼（UPA）的长期实际疗效和治疗模式进行评估的数据。我们评估了开始使用UPA的成年RA患者在长达12个月的时间里临床和患者报告结果的改善情况以及治疗模式：数据收集自CorEvitas® RA注册中心（08/2019-04/2022）。符合条件的患者为中度至重度RA（临床疾病活动指数[CDAI]>10），并在开始使用UPA后6个月或12个月进行随访。研究结果包括与基线相比的平均变化、临床和患者报告结果中达到最小临床重要差异 (MCID) 的百分比以及随访时的疾病活动度。我们评估了有肿瘤坏死因子抑制剂（TNFi）治疗经验的患者、接受UPA一线治疗的患者以及接受UPA单药治疗与联合治疗的患者的临床结果和治疗变化。我们还进一步评估了继续接受治疗的患者的疗效是否相似：结果：接受 UPA 治疗的患者（6 个月队列，N = 469；12 个月队列，N = 263）的疗效有显著的统计学改善（p 结论：接受 UPA 治疗的患者的疗效有显著的统计学改善（p 结论：接受 UPA 治疗的患者的疗效有显著的统计学改善（p 结论）：UPA的启动与临床和患者报告结果的改善有关，无论患者之前是否接受过TNFi治疗、治疗方案或同时使用常规疗法，UPA都能带来有意义的临床改善。要更好地了解UPA在更长治疗期内的持续反应，还需要进一步的研究。

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Real-World Use and Effectiveness Outcomes in Patients with Rheumatoid Arthritis Treated with Upadacitinib: An Analysis from the CorEvitas Registry.

Introduction: Data assessing longer-term real-world effectiveness and treatment patterns with upadacitinib (UPA), a Janus kinase inhibitor, in rheumatoid arthritis (RA) are lacking. We assessed improvement in clinical and patient-reported outcomes and treatment patterns for up to 12 months among adult patients with RA initiating UPA.

Methods: Data were collected from the CorEvitas^® RA Registry (08/2019-04/2022). Eligible patients had moderate to severe RA (Clinical Disease Activity Index [CDAI] > 10) and follow-up visits at 6 or 12 months after UPA initiation. Outcomes were mean change from baseline, percentage achieving minimal clinically important differences (MCID) in clinical and patient-reported outcomes, and disease activity at follow-up. We evaluated clinical outcomes and therapy changes among patients with tumor necrosis factor inhibitor (TNFi) experience and among those receiving UPA as first-line therapy, as well as those receiving UPA as monotherapy versus as part of combination therapy. We further evaluated whether outcomes were similar among those that remained on therapy.

Results: Patients treated with UPA (6-month cohort, N = 469; 12-month cohort, N = 263) had statistically significant improvements (p < 0.001) in mean CDAI, tender/swollen joint counts, pain, and fatigue at follow-up. At 12 months, 46.0% achieved MCID in CDAI and 40.0% achieved low disease activity/remission. Overall, 43.0% discontinued UPA at 12 months; of those receiving combination treatment (N = 90) with conventional therapies and UPA, 42.2% (N = 38) discontinued conventional therapy. Findings were similar in the 6-month cohort and among subgroups. Changes from baseline and proportions of patients achieving MCID or clinical outcomes tended to be numerically lower among patients with TNFi experience and numerically higher among those receiving UPA as first-line therapy.

Conclusions: UPA initiation was associated with improvements in clinical and patient-reported outcomes, with meaningful clinical improvements regardless of prior TNFi experience, line of therapy, or concomitant use of conventional therapies. Further research is needed to better understand sustained response of UPA over longer treatment periods.

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来源期刊

Rheumatology and Therapy RHEUMATOLOGY-

CiteScore

6.00

自引率

5.30%

发文量

审稿时长

6 weeks

期刊介绍： Aims and Scope Rheumatology and Therapy is an international, open access, peer reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world and health outcomes research around the discovery, development, and use of rheumatologic therapies. Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also welcomed. Areas of focus include, but are not limited to, rheumatoid arthritis, gout, gouty arthritis, psoriatic arthritis, osteoarthritis, juvenile idiopathic/rheumatoid arthritis, systemic lupus erythematosus, axial spondyloarthritis, Pompe’s disease, inflammatory joint conditions, musculoskeletal conditions, systemic sclerosis, and fibromyalgia. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, case reports, trial protocols, communications and letters. 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