Efficacy of adalimumab in the treatment of refractory rheumatoid arthritis and its influence on bone metabolism
Objective To explore the efficacy of adalimumab in the treatment of refractory rheumatoid arthritis(RRA)and its influence on bone metabolism.Methods 42 patients with RRA were treated with adalimumab.The relevant indexes were compared before treatment,1,3 and 6 months after treatment,and the use of related drugs before and after treatment and the occurrence of adverse drug reactions during treatment were observed.Results After 1,3,and 6 months of treatment,the levels of C-reactive protein(CRP),swollen joint count(SJC),tender joint count(TJC),28-joint disease activity score(DAS28)were significantly different from those before treatment(P<0.05).After 3 and 6 months of treatment,the erythrocyte sedimentation rate(ESR),osteocalcin and procollagen Ⅰ N terminal peptide(PⅠNP)were significantly different from those before treatment(P<0.05).Before adalimumab treatment,10 patients were treated with hormone therapy,and after 3 months of treatment,only 4 patients were treated with hormone therapy,and the amount of hormone used was significantly reduced,and only 1 patient was still using small doses of hormone after 6 months of treatment.After 1,3,and 6 months of treatment,the types of combining disease-modifying antirheumatic drugs(DMARDs)decreased.After 6 months of treatment,10 cases did not use DMRADs,31 cases used 1 DMRADs,and 1 case used 2 DMRADs.During the 6-month adalimumab treatment,1 of the 42 patients developed a scattered rash on the arm on the side of the injected arm on the 3rd day after the first injection,accompanied by mild itching.No special treatment was given,and the symptoms improved within 24 h,and the above symptoms did not occur again after follow-up treatment.1 patient was infected with herpes zoster after 3 months of use,and was given antiviral treatment by dermatology,and recovered about 10 days later.The remaining 40 patients had no serious adverse events such as local redness,swelling,rash,infection and tumor.Conclusion Adalimumab in the treatment of RRA patients can significantly improve the curative effect,reduce disease activity and improve bone metabolism.Adalimumab has low incidence of adverse events and high safety.
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