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《最新Biologics for rheumatoid arthritis an overview of Cochr：類風(fēng)濕性關(guān)節(jié)炎的生物制劑cochr概述-藥學(xué)醫(yī)學(xué)精品資料.ppt》由會(huì)員上傳分享，免費(fèi)在線閱讀，更多相關(guān)內(nèi)容在教育資源-天天文庫。
1、最新BiologicsforrheumatoidarthritisanoverviewofCochr：類風(fēng)濕性關(guān)節(jié)炎的生物制劑cochr概述-藥學(xué)醫(yī)學(xué)精品資料ClinicalquestionDobiologicdisease-modifyinganti-rheumaticdrugs(DMARDs)helprelievesymptomsofrheumatoidarthritisandreducediseaseprogression?Source:SinghJA,ChristensenR,WellsGA,Sua
2、rez-AlmazorME,BuchbinderR,Lopez-OlivoMA,TanjongGhogomuE,TugwellP.Biologicsforrheumatoidarthritis:anoverviewofCochranereviews.CochraneDatabaseofSystematicReviews2009,Issue4.Art.No.:CD007848.DOI:10.1002/14651858.CD007848.pub2.CochraneJournalClubContextRheuma
3、toidarthritisaffectsupto1in100peopleItcausesconsiderablediscomfortandlimitsqualityoflife,andcanleadtoseverejointdestructionBiologicDMARDsinhibittumournecrosisfactororothercytokinesorcellsthatcontributetojointinflammationanddestructioninRA.CochraneJournalCl
4、ubResults:ACR5027RCTs,including20thatusedconcomitantmethotrexateBiologicDMARDsvsplacebo:Combined,anybiologicDMARDmoreeffectivethanplaceboIndividually,thebiologicDMARDsare2to3timesmoreeffectivethanplacebo(exceptforanakinra)Number-needed-to-treat-to-benefit(
5、NNTB)rangedfrom3to5formostbiologicDMARDsBiologicDMARDvsotherbiologicDMARD:BiologicDMARDshavesimilareffectsButthereareexceptions–etanercept,rituximab,andadalimumabareallsuperiortoanakinraCochraneJournalClubResults:Withdrawalsduetoadverseevents29RCTs,includi
6、ng21thatusedconcomitanttherapy(generallymethotrexate,anotherDMARD)BiologicDMARDsvsplacebo:Higherriskofwithdrawalswithadalimumab,anakinra,andinfliximabSimilarriskofwithdrawalswithabatacept,etanercept,andrituximabBiologicDMARDvsotherbiologicDMARD:Morewithdra
7、walswithadalimumab,anakinra,andinfliximabthanwithetanerceptCochraneJournalClubResultsCochraneJournalClubSummaryoffindingstable:ACR50BiologicControlgroupriskBiologicriskRelativeRiskParticipants&studiesQualityofevidenceNNT(95%CI)Abatacept207per1000474per1000
8、2.29(1.62to3.24)1712(6studies)⊕⊕⊕?Moderate4(3to8)Adalimumab207per1000631per10003.05(2.29to4.07)2269(8studies)⊕⊕⊕?Moderate3(2to4)Anakinra207per1000271per10001.31(0.81to2.12)815(3studies)⊕⊕⊕?ModerateEtanercept2
