股骨骨矿物质密度是治疗类风湿性关节炎的个性化医疗工具:白细胞介素-6抑制剂适用于低密度患者,而肿瘤坏死因子抑制剂适用于高密度患者?

IF 2.3 Q2 MEDICINE, GENERAL & INTERNAL SAGE Open Medicine Pub Date : 2024-09-20 eCollection Date: 2024-01-01 DOI:10.1177/20503121241277498
Hirokazu Takaoka, Tomohiro Miyamura, Kota Shimada
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引用次数: 0

摘要

目的:在类风湿性关节炎的治疗中,缺乏区分白细胞介素-6 抑制剂应答者和肿瘤坏死因子抑制剂应答者的指标。骨质疏松症是类风湿关节炎的并发症之一,与炎症病理密切相关。本研究的目的是评估骨矿密度能否区分类风湿性关节炎患者中的白细胞介素-6抑制剂应答者和肿瘤坏死因子抑制剂应答者:方法:白细胞介素-6抑制剂或肿瘤坏死因子抑制剂作为第一种生物制剂,被初次接受皮质类固醇和骨质疏松症治疗的患者使用。分析了基线骨矿密度与 3 个月后临床疾病活动指数之间的相关性:受试者为 26 名类风湿性关节炎患者,中位年龄为 60 岁,病程为 1.4 年,临床疾病活动指数为 13.7,C 反应蛋白为 1.69 mg/dL。受试者根据股骨骨质密度分为两组(高(H)组和低(L)组),以年轻人平均骨质密度为 80% 为分界线。H组中的6人和L组中的11人接受了白细胞介素-6抑制剂治疗,H组中的9人接受了肿瘤坏死因子抑制剂治疗。白细胞介素-6抑制剂的临床疾病活动指数缓解率在L组(8/11(72.7%))明显高于H组(1/6(16.7%);P P = 0.04):在类风湿性关节炎患者中,白细胞介素-6抑制剂可能对股骨骨质密度低的患者更有益,而肿瘤坏死因子抑制剂可能对骨质密度有保留的患者更有利。
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Femoral bone mineral density as a tool of personalized medicine for rheumatoid arthritis: Interleukin-6 inhibitors for patients with low density whereas tumor necrosis factor inhibitor for patients with preserved density?

Objectives: There is a lack of indicators to distinguish between interleukin-6 inhibitors responders and tumor necrosis factor inhibitors responders in the treatment of rheumatoid arthritis. Osteoporosis is a complication of rheumatoid arthritis and is closely related to inflammatory pathology. The purpose of this study was to evaluate whether bone mineral density can distinguish interleukin-6 inhibitors responders from tumor necrosis factor inhibitors responders in rheumatoid arthritis.

Methods: Either interleukin-6 inhibitors or tumor necrosis factor inhibitors was introduced as the first biologics to patients naïve to both corticosteroid and osteoporosis treatment. Correlations between baseline bone mineral density and Clinical Disease Activity Index after 3 months were analyzed.

Results: The subjects were 26 rheumatoid arthritis patients with a median age of 60 years old, disease duration of 1.4 years, Clinical Disease Activity Index of 13.7, and C-reactive protein of 1.69 mg/dL. The subjects were divided into two groups (high (H) and low (L)) according to their femoral bone mineral density with a cutoff of young adult mean of 80%. Six in group H and 11 in group L received interleukin-6 inhibitors, and nine in group H received tumor necrosis factor inhibitors. Clinical Disease Activity Index remission rate by interleukin-6 inhibitors was significantly greater in group L (8/11 (72.7%)) than in group H (1/6 (16.7%); p < 0.05). In the whole group H, significantly more patients obtained Clinical Disease Activity Index remission by tumor necrosis factor inhibitors (7/9, 77.8%) than by interleukin-6 inhibitors (1/6 (16.7%); p = 0.04).

Conclusions: In patients with rheumatoid arthritis, interleukin-6 inhibitors may be more beneficial for patients with low femoral bone mineral density, whereas tumor necrosis factor inhibitors may be advantageous for those with preserved bone mineral density.

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来源期刊
SAGE Open Medicine
SAGE Open Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
3.50
自引率
4.30%
发文量
289
审稿时长
12 weeks
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