Efficacy evaluation of tofacitinib combined with methotrexate in the treatment of refractoryrheumatoid arthritis
托法替布联合甲氨蝶呤治疗难治性类风湿关节炎疗效评价

摘要

目的 分析难治性类风湿关节炎患者应用托法替布联合甲氨蝶呤的治疗效果。方法 选择我院收治的200例难治性类风湿关节炎患者作为研究对象，选取时间为2019年11月至2021年11月，按随机数字表法随机均分为参照组和治疗组（每组100例），前者给予来氟米特联合甲氨蝶呤（与开题方案相差较多）治疗，后者给予托法替布联合甲氨蝶呤治疗，比较两组健康评定量表（HAQ）评分、视觉模拟（VAS）评分、类风湿因子以及C-反应蛋白水平、ACR病情改善、DAS28评分、SHARP评分。结果 较参照组，治疗组HAQ评分、VAS评分、类风湿因子、C-反应蛋白水平、不良反应发生率、肿胀及压痛关节数更低（P<0.05）。治疗组ACR病情改善明显优于参照组（P<0.05），3个月、6个月DAS28评分明显较低（P<0.05）。治疗组3个月、6个月DAS28评分明显低于参照组，差异有统计学意义（P<0.05）。两组1个月DAS28评分比较、1个月、3个月、6个月SHARP评分比较，差异无统计学意义（P>0.05）。结论 托法替布联合甲氨蝶呤治疗难治性类风湿关节炎效果不错，值得在临床中提倡使用。

Abstract

Objective To analyze the therapeutic effect of tofacitinib combined with methotrexate in patients with refractory rheumatoid arthritis.
Methods 200 patients with refractory rheumatoid arthritis admitted to our hospital were selected as the research objects, and the selection time was from November 2019 to November 2021, and they were randomly divided into the reference group and the treatment group (each group) according to the random number table method. group of 100 cases), the former was treated with leflunomide combined with methotrexate (which was much different from the prescribed plan), and the latter was treated with tofacitinib combined with methotrexate. The health assessment scale (HAQ) of the two groups was compared Score, visual analogue (VAS) score, rheumatoid factor and C-reactive protein levels, ACR disease improvement, DAS28 score, SHARP score.
Results Compared with the reference group, the treatment group had lower HAQ score, VAS score, rheumatoid factor, C-reactive protein level, incidence of adverse reactions, swelling and tender joints (P<0.05). The improvement of ACR in the treatment group was significantly better than that in the control group (P<0.05), and the DAS28 score at 3 months and 6 months was significantly lower (P<0.05). The DAS28 score of the treatment group at 3 months and 6 months was significantly lower than that of the reference group, and the difference was statistically significant (P<0.05). There was no significant difference in the DAS28 score at 1 month, and the SHARP score at 1 month, 3 months, and 6 months between the two groups (P>0.05).
Conclusion   Tofacitinib combined with methotrexate has a good effect in the treatment of refractory rheumatoid arthritis, and it is worth promoting in clinical practice.