RA用每周1次的依那西普治疗虽可改善DAS28评分，但不抑制关节损伤

摘要 目的：已证实，每周两次25mg依那西普（TW）对类风湿关节炎（RA）患者有效。然而，为解决抗风湿生物制剂的经济负担，也在开始尝试使用每周一次25mg依那西普（OW）的治疗方式。本研究评估接受TW或OW患者随访2年时的临床和影响学改善情况。方法：63例初次使用生物制剂的RA患者随机分成两组，接受TW（n=42）或OW（n=21）治疗。结果：从基线到随访至2年时，临床缓解率（DAS-28<2 .3）在ow组（从1.6%至39.0%）和tw组（从9.5%至47.6%）均有明显改善，但在第2年时两组之间无显著差异。采用改良的sharp评分评价影像学显示的关节损伤，结果显示与tw组相比，ow组关节损伤进展显著。接受tw治疗的患者，关节损害进展可能被抑制或缓解。结论：这些结果显示，以das-28评价临床缓解时，在首次使用生物制剂的ra患者中ow治疗可有效替代tw治疗。然而，tw治疗对阻止关节损伤的加重是必不可少的。

附原文：OBJECTIVES: The twice-weekly administration of 25 mg of etanercept (TW) has been shown to be effective in patients with rheumatoid arthritis (RA). However, the once-weekly administration of 25 mg of etanercept (OW) was tried in order to address the economic burden of anti-rheumatic biologics. We evaluated the clinical and radiographic results from a 2-year follow-up study of patients receiving OW or TW. METHODS: Sixty-three biologics-naive patients with RA were randomly assigned to receive either OW (n = 42) or TW (n = 21). RESULTS: From baseline to year 2, rates of clinical remission, according to the Disease Activity Score of 28 joints (DAS-28) (based on C-reactive protein; CRP)-with clinical remission being regarded as a DAS-28 (CRP) score of <2 .3-were significantly improved in the ow group (from 1.6 to 39.0%) and in the tw group (from 9.5 to 47.6%), but no significant between-group difference was observed at year 2. radiographic joint damage, quantified with the modified sharp score, was significantly progressive in the ow group in contrast to findings in the tw group. thus, among patients receiving tw therapy, the progression of joint damage may have been inhibited or may have shown remission. conclusions: these results suggest that, in terms of das-28 remission, ow therapy can efficiently substitute for tw therapy in biologics-naive patients with ra. however, tw therapy was indispensable in preventing the worsening of joint damage.

引自：Wada T, Son Y, Ozaki Y, et al. Clinical and radiographic results from a 2-year comparison of once-weekly versus twice-weekly administration of etanercept in biologics-naive patients with rheumatoid arthritis. Mod Rheumatol. 2012 Feb 3. [Epub ahead of print]