强克与艾拉莫德联合治疗类风湿关节炎

目的 探讨短期使用重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白（rhTNFR：Fc强克）与艾拉莫德联合治疗类风湿关节炎（RA）的有效性和安全性.方法 对16例患者随机分为实验组11例和对照组5例,实验组给予强克皮下注射治疗3个月,每周1次,每次50 mg,同时给予艾拉莫德治疗,每日2次,每次25 mg.对照组给予艾拉莫德,剂量及方法同实验组,疗程3个月,随时观察并记录治疗过程中的任何不良事件,在0、2、4、8、12周监测血常规、红细胞沉降率（ESR）、肝功能、肾功能、类风湿因子（RF）、抗环瓜氨酸肽（CCP）抗体.结果 实验组和对照组在ACR20、ACR70、ESR、及CRP实验室指标均较入组时有明显改善,但两组间差异无统计学意义（P＞0.05）.治疗12周实验组停用强克时,两组的上述指标均进一步改善,两组间的不良反应率比较差异无统计学意义.结论 短期强克与艾拉莫德联合治疗重症RA,可以减少强克的疗程,有效缓解RA的症状和降低抗体水平,并不增加不良反应,具有较好的安全性.

Combined therapy of Qiangke and Iguratimod for rheumatoid arthritis

Objective To investigate the effect and safety of recombinant human 11 type of tumor necrosis factor receptor-an- tibody fusion protein （Qiangke） combined with Iguratimod in the short-term treatment of rheumatoid arthritis. Methods Sixteen patients with rheumatoid arthritis were randomly divided into two groups, 11 cases in the experiment group and 5 cases in the con- trol group, the experiment group was treated with hypodermic injection of recombinant human II type of tumor necrosis factor re- ceptor-antibody fusion protein （Qiangke） , 50 mg, once a week and Iguratimod 25 mg, twice a day for three months. The control group was given Iguratimod for three months, the dosage and method was the same as the experiment group, the course was 3 months. The adverse events at any time in the course of treatment were observed and recorded. Meanwhile, the level of blood routine examination, the erythrocyte sedimentation rate （ ESR）, liver and kidney functions, rheumatoid factor（ RF）, and anti-cy- clic citrullinated peptide （anti-CCP） antibodies before treatment and 2 weeks, 4 weeks, 8 weeks, 12 weeks after treatment were monitored. Results The experiment group and the control group had showed significant improvements after treatment in ACR20, ACR70, ESR, and CRP, but there was no significant difference between the two groups（P 〉0. 05）. The above indexes of the two groups were all further improved when the experiment group stopped Qiangke therapy at 12th weeks, the difference between the two groups in the rate of adverse reactions was not significant. Conclusion Recombinant human II type of tumor necrosis factor receptor-antibody fusion protein （Qiangke） combined with Iguratimod in the short-term treatment of severe rheumatoid ar- thritis has better safety, which can shorten the treating course of Qiangke, relieve the symptoms of rheumatoid arthritis effectively, and reduce the levels of antibodies with no increase in adverse reactions.