Clinical observation of tofacitinib combined with hydroxychloroquine in the treatment of refractory rheumatoid arthritis
- VernacularTitle:托法替布联合羟氯喹治疗难治性类风湿关节炎的临床观察
- Author:
Mingjie WANG
1
;
Fengjin XU
2
;
Yan ZHANG
2
;
Yan XUE
3
Author Information
1. Dept. of Rheumatology and Immunology，Hengshui Municipal People’s Hospital，Hebei Hengshui 053000，China;College of Clinical Medicine，Hebei Medical University，Shijiazhuang 050017，China
2. Dept. of Rheumatology and Immunology，Hengshui Municipal People’s Hospital，Hebei Hengshui 053000，China
3. Dept. of General Medicine，Hengshui Municipal People’s Hospital，Hebei Hengshui 053000，China
- Publication Type:Journal Article
- Keywords:
refractory rheumatoid arthritis;
tofacitinib
- From:
China Pharmacy
2024;35(6):729-733
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To observe the clinical efficacy and safety of tofacitinib combined with hydroxychloroquine in the treatment of refractory rheumatoid arthritis （RA）. METHODS From January 1， 2021 to January 1， 2022， 120 patients with refractory RA were selected as the study objects. According to the principle of random allocation， the patients were divided into group A， group B and group C， with 40 patients in each group. Group A was given Tofacitinib citrate tablet + Hydroxychloroquine sulfate tablet； group B was given Tofacitinib citrate tablet + Methotrexate tablet； group C was given Tofacitinib citrate tablet + Leflunomide tablet. Three groups were given relevant medicine for 6 months. Therapeutic efficacy and disease activity score 28 （DAS 28） of 3 groups as well as Sharp score， the levels of biochemical indicators [erythrocyte sedimentation rate （ESR）， C- reactive protein （CRP）]， immune indexes [rheumatoid factor （RF）， anti-cyclic peptide containing citrulline （anti-CCP） antibody]， serum cytokine indicators [interleukin-6 （IL-6） and tumor necrosis factor-α （TNF-α）] before and after treatment were observed； the occurrence of adverse drug reactions during treatment was recorded. RESULTS After treatment， the proportions of ACR50 and ACR70 patients in group A were significantly higher than groups B and C （P＜0.05）； DAS28 score， Sharp score， biochemical indicators， immune indexes and serum cytokine indicators of 3 groups were significantly lower than before treatment （P＜0.05）， and gradually decreased with prolonged treatment time； after 6 months of treatment， DAS28 score， Sharp score， RF， anti-CCP antibody， the levels of IL-6 and TNF-α in group A were significantly lower than group B and C （P＜0.05）. There was no significant difference in the incidence of diarrhea， nausea and vomiting， leukopenia， rash， abnormal liver and kidney function， or dizziness among 3 groups （P＞0.05）. CONCLUSIONS Tofacitinib combined with hydroxychloroquine shows good efficacy and safety for refractory RA.
