Abatacept风湿性关节炎。

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麦克斯韦L,辛格农协

Abatacept风湿性关节炎。

科克伦数据库系统启2009 10月7;(4):CD007277。cd007277.pub2 doi: 10.1002/14651858.。

PubMed ID

19821401 (在PubMed

]

文摘

背景:Abatacept抑制T细胞和扰乱了炎症的co-stimulation一系列事件导致关节炎症、疼痛、风湿性关节炎和损伤。目的:评估abatacept减少疾病的疗效和安全性活动,疼痛,改善类风湿性关节炎患者的功能。搜索策略:我们搜索Cochrane中央注册的对照试验(中央)(Cochrane图书馆2007年,问题1),MEDLINE(从1966年)、EMBASE(从1980年),ACP杂志俱乐部(2000年),和生命现象预览(从1990年)2007年3月和2008年12月。我们联系的作者包括研究和abatacept制造商。选择标准:abatacept随机对照试验,或结合疾病修饰风湿性关节炎药物(DMARDs)或生物制剂,安慰剂或其他DMARDs或生物制剂在中度到重度类风湿关节炎患者。数据收集和分析:两位作者独立的搜索结果和风险评估偏差,并提取数据。我们从试验获得不良事件数据,长期的扩展研究,和监管机构。主要结果:七个试验包括2908名患者。abatacept组与安慰剂相比,患者是2.2倍更有可能实现ACR 50响应一年(RR 2.21, 95%可信区间(CI) 1.73 - 2.82)和21%(95%可信区间16%到27%)绝对风险差异组。治疗所需的数量达到50 ACR反应5 (95% CI 4 - 7)。极大改善身体功能,减少疾病活动和痛苦abatacept-treated患者被发现与安慰剂相比。 One RCT found abatacept significantly slowed the radiographic progression of joint damage at 12 months compared to placebo, although it is not clear what the clinical relevance of this difference may be. There may be a risk of attrition bias. Total adverse events were greater in the abatacept group (RR 1.05, 95% CI 1.01 to 1.08). Other harm outcomes were not significant with the exception of a greater number of serious infections at 12 months in the abatacept group (Peto odds ratio 1.91 (95% CI 1.07 to 3.42). Serious adverse events were increased when abatacept was given in combination with other biologics (RR 2.30, 95% CI 1.15 to 4.62). AUTHORS' CONCLUSIONS: There is moderate-level evidence that abatacept is efficacious and safe in the treatment of rheumatoid arthritis. Abatacept should not be used in combination with other biologics to treat rheumatoid arthritis. The withdrawal and toxicity profile appears acceptable at the present time but further long-term studies and post-marketing surveillance are required to assess harms and sustained efficacy.

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药物

Abatacept