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題 名 | Improvement of Active Rheumatoid Arthritis After Etanercept Injection : A Single-center Experience=恩博注射可改善活動性類風濕性關節炎病情:單一醫學中心的經驗報告 |
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作 者 | 蘇桂英; 李惠婷; 周昌德; 蔡世滋; 陳瑋昇; 蔡長祐; | 書刊名 | Journal of the Chinese Medical Association |
卷 期 | 72:11 2009.11[民98.11] |
頁 次 | 頁581-587+CA108 |
分類號 | 415.695 |
關鍵詞 | 生物製劑療法; 恩博; 類風濕性關節炎; 腫瘤壞死因子; Biological therapies; Etanercept; Rheumatoid arthritis; Tumor necrosis factor-α; |
語 文 | 英文(English) |
英文摘要 | Background: To study the clinical effectiveness and adverse reactions of etanercept in patients with active rheumatoid arthritis (RA), in whom combination therapies with disease-modifying antirheumatic drugs (DMARDs) had failed. Methods: One hundred and thirty-three patients with active RA who had been treated without satisfactory effect with DMARDs were entitled, by the Taiwan Bureau of National Health Insurance, to undergo etanercept injection (25 mg subcutaneously, twice weekly) along with oral methotrexate (15 mg weekly) in Taipei Veterans General Hospital. The disease activity score in 28 swollen and 28 tender joints (DAS28), erythrocyte sedimentation rate (ESR), serum C-reactive protein (CRP), rheumatoid factors (RFs), tender joint count (TJC), and swollen joint count (SJC) were recorded at the beginning, 3, 6, 9, and 12 months after treatment. Any adverse event, relevant or irrelevant to the therapy, was recorded throughout the whole course of treatment. Results: Ninety-four patients completed the 1-year therapeutic program. There were significant improvements in all parameters (DAS28, ESR, CRP, TJC and SJC), which approached satisfactory values at the end of the first 3 months and which were sustained thereafter in most patients. Patients also tolerated the treatment protocol well, with adverse events occurring sporadically. Significant clinical response occurred as early as 3 months after the start and might last beyond 1 year in some patients. Adverse effects such as injection site reaction or infections rarely occurred. Conclusion: Combination therapy with etanercept and DMARDs seemed to be effective at improving the aching symptoms associated with rheumatoid activity and was well tolerated in this cohort study. It was generally safe, though a small number of non-fatal infections were observed. |
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