GLP-1RA类药物的市场分析

目的:对新型注射类降糖药GLP-1RA类药物进行市场分析,以求GLP-1RA类药物可以充分发挥市场潜力,提升市场影响力.方法:运用灰色系统理论均值GM(1,1)模型对GLP-1RA类药物未来5年的全球销售额进行预测,分析其在目前市场中存在的问题,并提出相关建议.结果:未来5年GLP-1RA类药物在全球市场的销售额将一直...     

Trends in RA patients’ adherence to subcutaneous anti-TNF therapies and costs

ABSTRACT

Objective: To examine adherence to adalimumab (ADA) and etanercept (ETA) and health care costs in rheumatoid arthritis (RA) patients, and to explore the association between adherence, utilization and costs.

Research design and methods: Using administrative claims data from a large managed health care plan, RA patients treated with etanercept or adalimumab during the period from 01/01/2005 through 12/31/2005 were identified. The first dispensing date was defined as the index date. Patient adherence and costs were assessed during the 1 year post-index period.

Main outcome measures: Nonadherence (medication possession ratio <80%) was modeled using logistic regression. Hazard ratios (HR) comparing time to discontinuation were estimated using Cox proportional hazard (PH) models. Propensity score matching with multivariate generalized linear modeling adjustment was done to assess cost difference between ADA and ETA.

Results: Of 3829 eligible RA patients, 1292 (765 existing, 527 naïve) and 2537 (1834 existing, 703 naïve) patients used ADA and ETA, respectively. Compared with ADA users, ETA users had longer average treatment duration (316 vs. 291 days; p?<?0.0001). Unadjusted adherence rates for naïve and existing users were 63% and 70% (ADA), and 65% and 73% (ETA). Logistic regression analysis indicated that compared with ETA users, ADA users were more likely to be nonadherent (OR, naïve 1.24; existing; 1.25). Cox PH models indicated that existing ADA users were more likely to discontinue (HR?=?1.11; p?=?0.06) their medication than existing ETA users. Compared with ADA users, ETA users had significantly lower RA-related pharmacy costs (naïve: $10,892 vs. $12,534, p?<?0.01; existing: $12,192 vs. $13,752, p?<?0.01) and RA-related total costs (naïve: $11,976.42 vs. $13,511.99, p?<?0.05; existing: $14,031 vs. $15,454, p?<?0.05).

Conclusions: ETA users had longer treatment duration, were more likely to adhere to their medication regimen and had lower RA-related pharmacy and RA-related total costs compared with ADA users. These findings must be considered within the limitations of this database analysis.     

GLP-1 RA应用于2型糖尿病合并脑卒中的研究进展

脑卒中具有高发病率、高致残率、高死亡率的特点,脑卒中与糖尿病息息相关,二者常伴随发生。近年来发现胰高血糖素样肽-1受体激动剂(GLP-1 receptor agonists, GLP-1 RA)应用于2型糖尿病合并脑卒中的患者可以有效改善其脑血管结局,提示GLP-1 RA在脑卒中的预防和治疗领域存在应用潜力。多项研究表明,GLP-1 RA可以通过降低脑卒中危险因素、保护脑组织、改善认知等机制来发挥其防治作用。本文就GLP-1 RA应用于脑卒中的机制进行综述,并从不良反应的视角探讨合理用药及防治措施。     

CP690550治疗RA有效

在第70届美国风湿病学会（ACR）年度科学会议和第43届风湿病保健专业协会年度会议的联合会议（ACR／ARCH）上公布的最新数据显示，CP690550（Ⅰ）治疗类风湿性关节炎（RA）有效。（Ⅰ）是一种口服有效的免疫抑制剂，可特异性抑制Janus激酶3（JAK3）。按照ACR的标准，     

08060 Ofatumumab治疗RA有效

根据一项剂量递增Ⅰ／Ⅱ期研究的结果，ofatumumab（Genmab，Medarex公司的Humax—CD20）（Ⅰ）可有效改善活动性类风湿性关节炎（RA）。在这项多中心、随机试验中，33例活动性RA患者输注两剂（Ⅰ）300mg（8例）、700mg（9例）或1000mg（9例）或安慰剂，间隔两周。     

黄芩苷抑制PDK1介导糖代谢重编程干预RA滑膜炎症

本研究从唇形科植物黄芩主要活性成分黄芩苷(baicalin,BC)对胶原诱导性关节炎(collagen-induced arthritis,CIA)大鼠作用出发,以类风湿关节炎(rheumatoid arthritis,RA)滑膜炎症关键效应细胞—成纤维样滑膜细胞(fibroblast like synoviocytes,FLSs)糖代谢重编程角度展开机制探讨。建立CIA大鼠模型和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)诱导的类风湿关节炎滑膜成纤维细胞(rheumatoid arthritis synovial fibroblasts,RASFs)体内外模型,观测BC给药后CIA大鼠关节炎指数(arthritis index,AI)评分及组织病理学变化,并ELISA法检测血清和细胞上清中炎症因子水平,免疫组织化学及Western blot法检测G蛋白偶联受体81 (G-protein-coupled receptor 81,GPR81)、丙酮酸脱氢酶激酶1 (pyruvate dehydrogenase kinase 1,PDK1)蛋白表达。试剂盒...     

RA33/36抗原及抗RA33/36抗体的研究进展

类风湿关节炎(rheumatoid arthritis,RA)是最常见的一种全身性自身免疫性疾病,以慢性、对称性、关节侵蚀性滑膜炎为主要表现,大多病情呈进行性,若未及时治疗,约1/3的病人将致残.因此,早期诊断、早期治疗是治疗类风湿关节炎的关键.     

IPAF和NALP1在RA滑膜中表达及其意义的探讨

目的通过检测并比较类风湿关节炎、骨关节炎及关节创伤者组滑膜中IPAF1的表达,探讨IPAF和NALP1在类风湿关节炎滑膜中的意义。方法免疫组化检测滑膜衬里层IPAF和NALP1蛋白质表达,于显微镜下观察,随机选取4个视野,连续计数100个位于滑膜衬里层的细胞及其中的阳性细胞数,取平均值,计算阳性细胞率,间接比较蛋白表达。结果滑膜组织免疫组化结果显示:RA组IPAF蛋白表达阳性率大于OA和Trauma组,差异均有统计学意义(P<0.05);NALP1仅在RA组表达,OA和Trauma组未见表达。结论 IPAF和NALP1在RA滑膜组织中有丰富表达,且其表达水平明显高于OA及Trauma组,提示IPAF和NALP1可能参与RA的慢性滑膜炎症过程。     

The mechanism of galanthamine regulating IL-1β/IL-1RA ratio to ameliorate inflammatory microenvironment

In the present study, we aimed to evaluate the anti-inflammatory mechanism of galanthamine, a classic therapeutic drug for Alzheimer’s disease (AD). The co-culture system of hippocampal nerve cell line HT-22 and microglial cell line BV-2 was established to observe the effect of galanthamine on the expressions of inflammatory factors induced by lipopolysaccharide (LPS). MTT method was used to observe the protective effect of galanthamine on neurons. ELISA and qPCR methods were used to detect the expressions of interleukin-1β (IL-1β) and IL-1 receptor antagonist (IL-1RA) at the protein and mRNA levels, respectively. IL-1β and IL-1RA were evaluated by the ELISA method after pretreating with galanthamine and α7 nAChR blocker α-bungarotoxin (α-bun), mAChR blocker atropine (Atr), PI3K inhibitor LY294002, IKKβ inhibitor SC514, or MEK inhibitor PD98059, respectively. The results showed that galanthamine significantly inhibited LPS-induced increased IL-1β and IL-1RA expressions and maintained the ratio of IL-1β/IL-1RA. α-Bun could block the regulatory effect of galanthamine on IL-1β and IL-1RA. As PI3K and NF-κB pathways were blocked, the regulatory effect of galanthamine on the IL-1β expression was significantly inhibited. Blocking PI3K and MEK pathways could significantly inhibit the regulation of galanthamine on IL-1RA expression. In summary, galanthamine regulated the inflammatory activity of the IL-1 subfamily to play an anti-inflammatory role mediated by α7 nAChR and PI3K/NF-κB/MAPK pathways, which probably provided a new strategy for AD treatment.     

抗CCP及抗RA33抗体与RF联合检测在RA中的意义

目的 :同时检测抗环瓜氨酸肽抗体 (Anti CCP抗体 )、抗RA3 3抗体和类风湿因子 (RF)在类风湿关节炎 (RA)中的敏感性及特异性 ,探讨三者联合检测在RA中的意义。方法 :采用ELISA检测抗CCP抗体及抗RA3 3抗体 ,乳胶凝集试验检测类风湿因子 (RF)。共检测 10 5例RA患者、4 0例非RA弥慢性结缔组织病、3 5例非风湿性疾病中的Anti CCP抗体、抗RA3 3抗体及RF的分布。比较三者之间的敏感性、特异性及三者联合检测的结果。结果 :Anti CCP抗体、抗RA3 3抗体及RF对RA的敏感性分别为 4 2 .9%、2 8.6%、4 7.6% ,特异性分别为 96%、92 %、5 6.0 %。RF与Anti CCP抗体结果差异无显著性 (P <0 .2 5 ) ,与Anti RA3 3抗体结果有显著性差异 (P <0 .0 2 5 )。Anti CCP抗体和Anti RA3 3抗体与RF的关系不密切。结论 :Anti CCP抗体和抗RA3 3抗体具有良好的敏感性及特异性 ,可视为RA早期诊断新的血清学指标 ,与RF联合检测能提高诊断RA的敏感性和特异性。Anti CCP抗体和抗RA3 3抗体与RF的关系不密切。     

RA治疗早期值得应用etanercept

在第69届美国风湿病学科研会议和第40届风湿病学卫生职业联盟（ACR／ARHP）会议中提出了一项模拟试验研究。该研究结果显示，etanercept（I）是继两种缓解疾病的抗类风湿性关节炎（RA）药（DMARDs）治疗失败之后的效价比较好的治疗选择。另外，研究者补充说，继一种DMARD治疗失败后，在治疗RA过程中，较早的应用（I）治疗有很好的价效比。     

Sativex可减轻RA引起的疼痛

英国的研究者报告称，GW公司的Cannabis药Sativex（I）可减轻类风湿性关节炎诱发的疼痛。     

08061 VX702有望用于RA

Ⅱ期研究的结果显示，Vertex公司的P38MAP激酶抑制剂VX702（Ⅰ）可能对改善类风湿性关节炎（RA）的症状和体征有效。     

治疗RA降低心血管病的风险

类风湿关节炎（RA）患者长期应用DMARDs、糖皮质激素和TNF—α抑制剂可降低心血管事件的风险,这个观点被最近一个多国研究者参加的多中心试验支持。该研究数据来自4363位正在接受上述治疗并且参与QUEST—RA研究的患者。     

Certolizumab可迅速缓解RA症状

UCB公司宣布的RAPID1试验的重要数据显示Cimzia（certolizumab pegol）（Ⅰ）与甲氨喋呤同用可迅速缓解活动性类风湿关节炎（RA）患者症状,并抑制其关节损害进展。     

Actemra显示对RA有潜力

中外公司／Roche公司的抗IL-6受体单克隆抗体Actemra（tocilizumab；MRA）（Ⅰ）的Ⅲ期试验资料显示其对类风湿性关节炎（RA）有潜力，可能成为治疗RA新种类药物中第一个产品。     

辉瑞：RA药物申请推迟

近日，辉瑞公司宣布，其已向FDA提交上市申请的风湿性关节炎治疗药物Tofacitinib的审查结果将推迟三个月公布，以准备更多数据来支持该药治疗效果的评估。     

预测全球RA市场将增长

来自市场研究公司Visiongain的一份报道指出，拥有近500万的全球市场最大患者群的风湿性的抗炎药物有利可图且由于新产品的上市将继续增长。