Accompanying the increased use of biological and non-biological antirheumatic drugs,a greater number of cases of hepatitis B virus(HBV) reactivation have been reported in inactive hepatitis B surface antigen(HBs Ag) c...Accompanying the increased use of biological and non-biological antirheumatic drugs,a greater number of cases of hepatitis B virus(HBV) reactivation have been reported in inactive hepatitis B surface antigen(HBs Ag) carriers and also in HBs Ag-negative patients who have resolved HBV infection. The prevalence of resolved infection varies in rheumatic disease patients,ranging from 7.3% to 66%. Through an electronic search of the Pub Med database,we found that among 712 patients with resolved infection in 17 observational cohort studies,12 experienced HBV reactivation(1.7%) during biological antirheumatic therapy. Reactivation rates were 2.4% for etanercept therapy,0.6% for adalimumab,0% for infliximab,8.6% for tocilizumab,and 3.3% for rituximab. Regarding non-biological antirheumatic drugs,HBV reactivation was observed in 10 out of 327 patients with resolved infection from five cohort studies(3.2%). Most of these patients received steroids concomitantly. Outcomes were favorable in rheumatic disease patients. A number of recommendations have been established,but most of the supporting evidence was derived from the oncology and transplantation fields. Compared with patients in these fields,rheumatic disease patients continue treatment with multiple immunosuppressants for longer periods. Optimal frequency and duration of HBV-DNA monitoring and reliable markers for discontinuation of nucleoside analogues should be clarified for rheumatic disease patients with resolved HBV infection.展开更多
Objective:Therapeutic effect of heatclearing and dampness-eliminating dredging collaterals combined with papaya antirheumatic pills on treatment of damp-heat obstructive ankylosing spondylitis.Methods:A total of 200 p...Objective:Therapeutic effect of heatclearing and dampness-eliminating dredging collaterals combined with papaya antirheumatic pills on treatment of damp-heat obstructive ankylosing spondylitis.Methods:A total of 200 patients with ankylosing spondylitis who were treated in our hospital from January 2018 to October 2019 were selected as the research objects and randomly divided into 2 groups,each with 100 patients.The control group was treated with leflunomide+papaya antirheumatic pills,and the observation group was treated with self-drafted recipe of heat-clearing and dampness-eliminating,the curative effect,visual analogue score(VAS),barthel AS function index(BASFI)score,biochemical indicators and adverse reactions between the two groups were compared.Results:After 12 weeks of treatment,the efficacy of the observation group was higher than that of the control group.The pain score,BASFI score,and biochemical index were lower than those of the control group,and the differences were statistically significant(P<0.05);There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Heat-clearing and dampnesseliminating dredging collaterals combined with papaya antirheumatic pills is effective in the treatment of damp-heat obstructive ankylosing spondylitis,which is beneficial to reduce the degree of pain and inflammation of the affected area,helps patients remain active,and improves activities of daily living.展开更多
A recent study published in World J Clin Cases addressed the optimal non-steroidal anti-inflammatory drugs(NSAIDs)for juvenile idiopathic arthritis(JIA).Herein,we outline the progress in drug therapy of JIA.NSAIDs hav...A recent study published in World J Clin Cases addressed the optimal non-steroidal anti-inflammatory drugs(NSAIDs)for juvenile idiopathic arthritis(JIA).Herein,we outline the progress in drug therapy of JIA.NSAIDs have traditionally been the primary treatment for all forms of JIA.NSAIDs are symptom-relief medications,and well tolerated by patients.Additionally,the availability of selective NSAIDs further lower the gastrointestinal adverse reactions compared with traditional NSAIDs.Glucocorticoid is another kind of symptom-relief medications with potent anti-inflammatory effect.However,the frequent adverse events limit the clinical use.Both NSAIDs and glucocorticoid fail to ease or pre-vent joint damage,and the breakthrough comes along with the disease-mo-difying antirheumatic drugs(DMARDs).DMARDs can prevent disease pro-gression and reduce joint destruction.Particularly,the emergence of biologic DMARDs(bDMARDs)has truly revolutionized the therapeutics of JIA,compared with conventional synthetic DMARDs.As a newly developed class of drugs,the places of most bDMARDs in the management of JIA remain to be well estab-lished.Nevertheless,the continuous evolution of bDMARDs raises hopes of improving long-term disease outcomes for JIA.展开更多
基金Supported by Research funds from the National Hospital Organization,Japan
文摘Accompanying the increased use of biological and non-biological antirheumatic drugs,a greater number of cases of hepatitis B virus(HBV) reactivation have been reported in inactive hepatitis B surface antigen(HBs Ag) carriers and also in HBs Ag-negative patients who have resolved HBV infection. The prevalence of resolved infection varies in rheumatic disease patients,ranging from 7.3% to 66%. Through an electronic search of the Pub Med database,we found that among 712 patients with resolved infection in 17 observational cohort studies,12 experienced HBV reactivation(1.7%) during biological antirheumatic therapy. Reactivation rates were 2.4% for etanercept therapy,0.6% for adalimumab,0% for infliximab,8.6% for tocilizumab,and 3.3% for rituximab. Regarding non-biological antirheumatic drugs,HBV reactivation was observed in 10 out of 327 patients with resolved infection from five cohort studies(3.2%). Most of these patients received steroids concomitantly. Outcomes were favorable in rheumatic disease patients. A number of recommendations have been established,but most of the supporting evidence was derived from the oncology and transplantation fields. Compared with patients in these fields,rheumatic disease patients continue treatment with multiple immunosuppressants for longer periods. Optimal frequency and duration of HBV-DNA monitoring and reliable markers for discontinuation of nucleoside analogues should be clarified for rheumatic disease patients with resolved HBV infection.
文摘Objective:Therapeutic effect of heatclearing and dampness-eliminating dredging collaterals combined with papaya antirheumatic pills on treatment of damp-heat obstructive ankylosing spondylitis.Methods:A total of 200 patients with ankylosing spondylitis who were treated in our hospital from January 2018 to October 2019 were selected as the research objects and randomly divided into 2 groups,each with 100 patients.The control group was treated with leflunomide+papaya antirheumatic pills,and the observation group was treated with self-drafted recipe of heat-clearing and dampness-eliminating,the curative effect,visual analogue score(VAS),barthel AS function index(BASFI)score,biochemical indicators and adverse reactions between the two groups were compared.Results:After 12 weeks of treatment,the efficacy of the observation group was higher than that of the control group.The pain score,BASFI score,and biochemical index were lower than those of the control group,and the differences were statistically significant(P<0.05);There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Heat-clearing and dampnesseliminating dredging collaterals combined with papaya antirheumatic pills is effective in the treatment of damp-heat obstructive ankylosing spondylitis,which is beneficial to reduce the degree of pain and inflammation of the affected area,helps patients remain active,and improves activities of daily living.
文摘A recent study published in World J Clin Cases addressed the optimal non-steroidal anti-inflammatory drugs(NSAIDs)for juvenile idiopathic arthritis(JIA).Herein,we outline the progress in drug therapy of JIA.NSAIDs have traditionally been the primary treatment for all forms of JIA.NSAIDs are symptom-relief medications,and well tolerated by patients.Additionally,the availability of selective NSAIDs further lower the gastrointestinal adverse reactions compared with traditional NSAIDs.Glucocorticoid is another kind of symptom-relief medications with potent anti-inflammatory effect.However,the frequent adverse events limit the clinical use.Both NSAIDs and glucocorticoid fail to ease or pre-vent joint damage,and the breakthrough comes along with the disease-mo-difying antirheumatic drugs(DMARDs).DMARDs can prevent disease pro-gression and reduce joint destruction.Particularly,the emergence of biologic DMARDs(bDMARDs)has truly revolutionized the therapeutics of JIA,compared with conventional synthetic DMARDs.As a newly developed class of drugs,the places of most bDMARDs in the management of JIA remain to be well estab-lished.Nevertheless,the continuous evolution of bDMARDs raises hopes of improving long-term disease outcomes for JIA.
