Effects of Adalimumab injection combined with Leflunomide in treatment of elderly patients with rheumatoid arthritis
Objective:To observe effects of Adalimumab injection combined with Leflunomide in treatment of elderly patients with rheumatoid arthritis(RA).Methods:A prospective study was conducted on 87 elderly patients with RA admitted to the hospital from March 2021 to March 2023.According to the random number table method,they were divided into control group(43 cases)and study group(44 cases).The control group was treated with Leflunomide,while the study group was treated with Adalimumab injection on the basis of that of the control group.The clinical efficacy,the clinical symptoms and the disease-related indexes[erythrocyte sedimentation rate(ESR),rheumatoid factor(RF),anti-cyclic citrullinated peptide(CCP)antibody]levels,the inflammatory factor[macrophage colony stimulating factor(M-CSF),interleukin-1β(IL-1β),C-reactive protein(CRP),cyclooxygenase-2(COX-2)]levels,the nuclear factor-κB(NF-κB)pathway-related indexes[NF-κB activator(Act1),NF-κB,NF-κB inhibitory protein α(IκBα)]levels,and the incidence of adverse reactions were compared between the two groups before and after the treatment.Results:The total effective rate of the study group was 93.18%(41/44),which was higher than 74.42%(32/43)of the control group,and the difference was statistically significant(P<0.05).After the treatment,the morning stiffness time of the two groups was shorter than that before the treatment,and that of the study group was shorter than that of the control group;the scores of joint tenderness,joint swelling and joint pain in the two groups were lower than those before the treatment,and those in the study group were lower than those in the control group;and the differences were statistically significant(P<0.05).The levels of ESR,RF and anti-CCP antibody in the two groups were lower than those before the treatment,those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of serum M-CSF,IL-1β,CRP and COX-2 in the two groups were lower than those before the treatment,and those in the study group were lower than those in the control group,the differences were statistically significant(P<0.05);the levels of Act1,NF-κB and IκBα mRNA in peripheral blood of the two groups were lower than those before the treatment,and those in the study group were lower than those in the control group;and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Adalimumab injection combined with Leflunomide in the treatment of the elderly patients with RA can improve the total effective rate of treatment,improve the clinical symptoms,and reduce the levels of disease-related indexes,inflammatory factors and NF-κB pathway-related indexes.Moreover,it is superior to single Leflunomide treatment.
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