现代医药卫生2026，Vol.42Issue(5)：1044-1048,1058,6.DOI:10.3969/j.issn.1009-5519.2026.05.019
乌帕替尼治疗难治性类风湿性关节炎的疗效与安全性分析
Efficacy and safety of upadacitinib in the treatment of difficult-to-treat rheumatoid arthritis
摘要
Abstract
Objective To evaluate the efficacy and safety of upadacitinib(UPA)in the treatment of pa-tients with difficult-to-treat rheumatoid arthritis(D2T-RA)in a real-world setting.Methods Adult patients with D2T-RA who were hospitalized or treated as outpatients in the hospital from May 2023 to April 2025 and received UPA were enrolled.Follow-up assessments were conducted at weeks 4,12,24,and 48.The changes in patients'low disease activity(LDA),inflammatory markers[C-reactive protein(CRP),erythrocyte sedimentation rate(ESR)},joint involvement indicators[28 tender joint count(TJC28),28 swollen joint count(SJC28)},pain visual analog scale(VAS),and the occurrence of adverse events were analyzed,and the CRP-based 28-joint disease activity score(DAS28-CRP),clinical disease activity index(CDAI),etc.were calculated.Results Within 48 weeks of follow-up,all efficacy indicators were significantly reduced compared with baseline(P<0.001).Among in-flammatory markers,C-reactive protein(CRP)decreased from 8.98(1.75,22.39)mg/L to 1.85(0.94,5.79)mg/L,and erythrocyte sedimentation rate(ESR)decreased from 32.50(18.75,49.00)mm/h to 16.00(9.75,23.00)mm/h.Regarding joint involvement,tender joint count in 28 joints(TJC28)decreased from 13.00(8.00,20.00)to 1.00(0.00,6.00),and swollen joint count in 28 joints(SJC28)decreased from 8.00(4.00,16.00)to 0.00(0.00,2.00).Clinical assessment indicators[VAS,health assessment questionnaire-disability index,DAS28-CRP,and CDAI,etc.]also showed a downward trend over time(P<0.001).Post hoc analysis demonstrated that all efficacy indicators improved significantly at an early stage of treatment(P<0.001).Ac-cording to DAS28-CRP criteria,the low disease activity(LDA)rates at weeks 4,12,24,and 48 were 31.34%,61.19%,68.66%,and 68.65%,respectively,while the remission rates were 23.88%,43.28%,59.70%,and 61.19%,respectively.According to CDAI criteria,the LDA rates at the corresponding time points were 22.39%,50.75%,64.18%,and 65.67%,respectively,and the remission rates were 10.64%,23.88%,34.32%,and 35.82%,respectively.The pain relief rate increased progressively from 38.80%at week 4 to 76.11%at week 48.The functional improvement rate also showed an increasing trend,reaching 19.40%,34.33%,49.25%,and 55.22%at weeks 4,12,24,and 48,respectively.No serious adverse events occurred during UPA treatment.Conclusion UPA demonstrated sustained and significant clinical efficacy in patients with D2T-RA,with good safety and tolerability.Its efficacy was not affected by previous treatments or con-comitant medications.关键词
难治性类风湿性关节炎/乌帕替尼/疗效/安全性Key words
Difficult-to-treat rheumatoid arthritis/Upadacitinib/Efficacy/Safety分类
医药卫生引用本文复制引用
孙淑玉,李嵩,常新,武剑..乌帕替尼治疗难治性类风湿性关节炎的疗效与安全性分析[J].现代医药卫生,2026,42(5):1044-1048,1058,6.基金项目
苏州市基础研究试点项目(SSD2024033). （SSD2024033）
