托法替布与益赛普分别联合甲氨蝶呤治疗难治性类风湿关节炎的疗效及安全性分析

目的 探究托法替布与肿瘤坏死因子（TNF）-α受体拮抗剂益赛普分别联合甲氨蝶呤治疗难治性类风湿关节炎（RRA）疗效及安全性。方法 采用随机数字表法将60例RRA患者分为A组、B组和C组，每组20例。A组采用枸橼酸托法替布（5 mg）联合甲氨蝶呤（10 mg）治疗，B组单用益赛普（25 mg）治疗，C组采用益赛普（25 ...

Efficacy and safety analysis of tofacitinib and yisaipu combined with methotrexate in the treatment of refractory rheumatoid arthritis

Objective To explore the effect and safety of tofacitinib and tumor necrosis factor-α receptor antagonist (yisaipu) combined with methotrexate in the treatment of refractory rheumatoid arthritis (RRA). Methods According to random number table method, 60 patients with RRA were divided into the group A, the group B and the group C, 20 cases in each group. The group A was treated with citrate tofacitinib (5 mg) and methotrexate (10 mg), the group B was treated with yisaipu (25 mg), and the group C was treated with yisaipu (25 mg) and methotrexate (10 mg). The clinical curative effects, clinical symptoms, disease activity indexes, inflammatory factors and adverse reactions were compared between different groups. Results After treatment, the clinical effective rate was significantly higher in the group A than that in the group B (P<0.05). However, there were no significant differences in indexes of clinical curative effect between the group A and the group C, and between the group B and the group C (P>0.05). After treatment, joint tenderness, joint swelling, levels of erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), C-reactive protein (CRP), serum interleukin (IL)-6, IL-1β and IL-17 were significantly decreased compared with before treatment in the three groups (P>0.05). The number of joint tenderness and joint swelling, morning stiffness time, levels of ESR, RF, CRP, IL-6, IL-1β and IL-17 were lower in the group A than those in the group B and the group C. The morning stiffness time, levels of ESR, RF, CRP, IL-6, IL-1β and IL-17 were lower in the group C than those in the group B (P<0.05). There was no significant difference in the incidence of adverse reactions during treatment between the three groups (P>0.05). Conclusion Tofacitinib combined with methotrexate has significant efficacy in the treatment of RRA, which is superior to yisaipu alone or yisaipu combined with methotrexate in clinical symptom improvement, disease activity index control and inflammatory factor level inhibition, with good safety.