摘要
目的:探讨AS患者英夫利西单抗(IFX)谷浓度(TLs)与疗效的关系,了解抗IFX抗体(ATI)产生情况。方法:连续纳入2017年1月至2018年12月苏北人民医院接受IFX治疗的AS患者38例。在第8次应用IFX前空腹抽取检测血清IFX-TLs和ATI水平,在第1次、第6次、第8次应用IFX前进行AS病情活动度评分(ASDAS),采用单因素方差分析、秩和检验、χ^2检验、Logistic回归分析进行统计学分析。从而进行疗效评价。结果:①38例AS患者,其中6例(16%)出现了ATI。这6例患者第8次IFX给药(38周)时出现病情反弹。②以第8次IFX治疗相比第6次IFX治疗的ASDAS是否上升进行分组,绘制受试者工作曲线(ROC)曲线,计算出IFX-TLs维持在0.635μg/ml以上时,患者病情不易反跳。③Logistic回归分析结果显示IFX-TLs与BMI相关[OR(95%CI)=1.536(1.023,2.308),P=0.039],与合并用药相关[OR(95%CI)=0.218(0.06,0.797),P=0.021]。结论:ATI的产生以及IFX-TLs变化与IFX失应答密切相关,应定期监测,调整治疗方案。
Objective To investigate the relationship between serum concentration of infliximab(IFX)and its impact on clinical efficacy to ankylosing spondylitis(AS)and explore the situation of antibodies to IFX(ATI).Methods A total of 38 AS patients treated with IFX from Jan 2017 to Dec 2018 at Hospital were enrolled.Serum IFX-trough levels(TLs)and ATI were detected before the 8th IFX treatment.Ankylosing spondylitis disease activity score(ASDAS)were measured at the first,6th,8th IFX treatment.The results were analyzed in relation to the clinical response to treatment.One-way analysis of variance,Kruskal-Wallis test,χ^2-test,Logistic regression were used for statistical analysis.Results①ATI against IFX were detected in6 patients(16%).②The increase of ASDAS in the 8th IFX treatment compared with the 6th IFX treatment was grouped.Based on the receiver operating characteristic curve(ROC),it was calculated that when IFX-TLs was maintained above 0.635μg/ml,the patient's condition could be kept stable.③Logistic regression analysis showed that IFX-TLs was related to BMI[OR(95%CI)=1.536(1.023,2.308),P=0.039]and drug combination[OR(95%CI)=0.218(0.06,0.797),P=0.021].Conclusion The ATI and IFX-TLs is related to the loss of response to IFX treatment.We suggest that the simultaneous measurement of ATI and IFX-TLs may further help to optimizethe therapy in critical situations.
作者
郁新迪
魏华
Yu Xindi;Wei Hua(Department of Rheumatology,People's Hospital in Subei,Jiangsu 225001,China)
出处
《中华风湿病学杂志》
CAS
CSCD
北大核心
2020年第2期116-119,共4页
Chinese Journal of Rheumatology
