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【medical-news】风湿性关节炎的关节炎症与破坏是
NEW YORK (Reuters Health), Nov 6 - Combination therapy with methotrexate and etanercept can slow radiographic progression of rheumatoid arthritis (RA) out of proportion to its effects on disease activity, according to a report in Arthritis & Rheumatism for October.
"Signs and symptoms of inflammation are (or can be) uncoupled from the destructive process of rheumatoid arthritis," Dr. Robert Landewe from University Hospital Maastricht in the Netherlands, told Reuters Health. "Since the treatment possibilities of RA rapidly expand, this opens a possibility to do a more targeted, maybe even individualized approach -- drug A to treat pain and stiffness, and drug B to stop destruction."
Dr. Landewe and colleagues used data from the TEMPO trial to investigate the relationship between disease activity and radiographic progression of joint destruction in RA patients treated with methotrexate, etanercept, and the combination of the two.
Radiographic progression rates increased with increased measures of disease activity in the methotrexate group and to a lesser extent in the etanercept group, the team reports, but there was no relationship between progression rates and disease activity measures in the combination treatment group.
In fact, the researchers note, the mean radiographic progression rate was negative for all subcategories of disease activity among patients receiving combination therapy (but not among those receiving monotherapy with either agent).
"We conclude from these data that there is now a good scientific rationale for the existence of a disconnect between inflammation and radiographic progression in patients treated with etanercept plus methotrexate and that this observation, together with those of the previous post hoc analysis of the data from the ATTRACT trial, suggests that this is a class-specific effect of TNF-inhibiting drugs," the investigators write.
"Our study has again confirmed that it is very important that we combine anti-TNF-drugs with methotrexate, and that it is only the combination of this drug that exerts optimal efficacy," Dr. Landewe concluded.
"The biologic explanation for this clinical observation is, however, far from clear," the authors add.
By Will Boggs, M.D. Joint inflammation and destruction are separate processes in rheumatoid arthritis
类风湿关节炎的关节炎症与关节破坏是不同的过程
NEW YORK (Reuters Health), Nov 6 - Combination therapy with methotrexate and etanercept can slow radiographic progression of rheumatoid arthritis (RA) out of proportion to its effects on disease activity, according to a report in Arthritis & Rheumatism for October.
氨甲蝶呤和益赛普联合治疗能够降低风湿性关节炎的影像学上病变进展速度，但是与这种改变与病变的实际严重程度并不成比例。
"Signs and symptoms of inflammation are (or can be) uncoupled from the destructive process of rheumatoid arthritis," Dr. Robert Landewe from University Hospital Maastricht in the Netherlands, told Reuters Health. "Since the treatment possibilities of RA rapidly expand, this opens a possibility to do a more targeted, maybe even individualized approach -- drug A to treat pain and stiffness, and drug B to stop destruction."
风湿性关节炎的症状和体征与关节破坏之间不是紧密相关的。随着风湿性关节炎的治疗方法的增多，可能需要多种药组合，实现个性化治疗，例如甲药治疗疼痛与关节强直，乙药治疗关节破坏。荷兰Maastricht大学医院的Robert Landewe博士高龄路透社。
Dr. Landewe and colleagues used data from the TEMPO trial to investigate the relationship between disease activity and radiographic progression of joint destruction in RA patients treated with methotrexate, etanercept, and the combination of the two.
Landewe博士小组研究了接受氨甲蝶呤和益赛普及两者相互结合治疗的风湿病人的资料，探讨疾病严重程度与关节破坏之间的关系，
Radiographic progression rates increased with increased measures of disease activity in the methotrexate group and to a lesser extent in the etanercept group, the team reports, but there was no relationship between progression rates and disease activity measures in the combination treatment group.
在氨甲蝶呤组病人，放射学上关节破坏的程度与病变程度相关，而再益赛普组相关的程度药若。但是两者相互组合后，关节破坏的影像学表现与临床症状间不在存有联系。
In fact, the researchers note, the mean radiographic progression rate was negative for all subcategories of disease activity among patients receiving combination therapy (but not among those receiving monotherapy with either agent).
研究小组注意到：接受联合治疗的病人的平均影像学上的关节破坏称阴性，但是这一现象不见于接受氨甲蝶呤或者其它单一药物的病人。
"We conclude from these data that there is now a good scientific rationale for the existence of a disconnect between inflammation and radiographic progression in patients treated with etanercept plus methotrexate and that this observation, together with those of the previous post hoc analysis of the data from the ATTRACT trial, suggests that this is a class-specific effect of TNF-inhibiting drugs," the investigators write.
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作者:admin@医学,生命科学 2011-07-04 18:05
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