EULAR应用合成和生物类改善病情抗风湿药治疗类风湿关节炎的推荐：2019更新

概要：工作组围绕传统合成（cs）DMARD、糖皮质激素（GC）、生物类（b）DMARD和生物类似（bs）DMARDs以及靶向合成（ts）DMARDs的应用，就5项主要原则和12项建议达成了一致，制订了有关疗效、安全性、优先顺序和成本的RA管理共识。

The task force agreed on 5 overarching principles and 12 recommendations concerning use of conventional synthetic (cs) DMARDs, glucocorticoids (GCs), biological (b) DMARDs and biosimilar (bs) DMARDs) and targeted synthetic (ts) DMARDs. These updated EULAR recommendations provide consensus on the management of RA with respect to benefit, safety, preferences and cost.

当前达标治疗模式下个别中低疾病活动度患者仍可出现影像学进展：来自荷兰类风湿关节炎监测登记库（DREAM）的真实世界证据

概要：对DREAM缓解诱导队列中患者基线到3年的随访数据进行的分析显示，按照达标治疗策略治疗的早期类风湿关节炎患者中，影像学进展似乎是由个体因素决定的，并不由持续的高疾病活动度驱动。

Baseline to 3-year follow-up data were used from patients included in the DREAM remission induction cohort. In early RA patients treated according to T2T, radiographic progression appears to be an individually determined disease process, driven by factors other than consistent high disease activity.

RRRR研究（随机对照试验）：英夫利西单抗加量策略治疗类风湿关节炎获得缓解后的持续停药率

概要：在甲氨蝶呤应答不充分的英夫利西单抗（IFX）初治类风湿关节炎患者中进行的这项多中心随机试验显示，根据基线血清TNFα水平调节IFX剂量的策略与IFX标准治疗方案（3 mg/kg）相比，并不能显著增加IFN停药1年后的持续缓解率。

In this multicentre randomised trial on patients with IFX-naïve rheumatoid arthritis with inadequate response to methotrexate, “programmed' infliximab (IFX) treatment strategy” (for which the dose of IFX was adjusted based on the baseline serum tumour necrosis factor α (TNF-α)) did not statistically increase the sustained remission rate after 1 year discontinuation of IFX treatment compare with standard treatment with 3 mg/kg of IFX.

德国GO-NICE研究的亚组分析：强直性脊柱炎启动肿瘤坏死因子抑制剂治疗的疾病活动度阈值

概要：对GO-NICE研究的一个亚组事后分析显示，约1/3的生物制剂初治强直性脊柱炎（AS）患者启动TNF抑制剂治疗时的疾病活动度低于当前推荐的阈值（BASDAI ≥4）。BASDAI介于2.8~4的患者用戈利木单抗治疗似乎能取得显著的获益。

This is a post hoc analysis of the noninterventional, prospective, GO-NICE study in the subgroup of biologic-naive AS treated with golimumab (GOL). TNFi treatment was initiated in almost a third of AS patients with lower disease activity states as assessed by BASDAI cutoff of≥4. Patients with a BASDAI between 2.8 and < 4 appeared to benefit significantly from GOL treatment.

美国CORRONA银屑病注册数据库中对乌司奴单抗治疗应答不充分的中重度银屑病患者的特征

概要：CORRONA银屑病注册数据库中178例在入组时开始乌司奴单抗治疗且有≥1次随访数据的中重度银屑病患者，6个月随访时55.6%获得应答。年龄较大与应答可能性下降显著相关。

Of 178 patients who initiated ustekinumab in the Corrona Psoriasis Registry and had 1 follow-up visit, 99 (55.6%) were classified as responders at the 6-month follow-up visit. Logistic regression modeling showed that increasing age was significantly associated with a decreased likelihood of achieving a response.

VOYAGE-1和VOYAGE-2试验结果示古塞奇尤单抗连续治疗3年，维持临床缓解且安全性与之前一致

概要：VOYAGE-1、2研究中，古塞奇尤单抗连续治疗中重度银屑病患者3年，PASI 90为82.8%和77.2%，PASI100为50.8%和48.8%，IGA-0/1为82.1%和83.0%，IGA-0为53.1%和52.9%。156周的安全事件发生率与100周的情况一致。这提示古塞奇尤单抗连续治疗3年的疗效持久，安全性与之前保持一致。

Three-year response rates for the guselkumab group in VOYAGE 1 and VOYAGE 2, respectively, were 82.8% and 77.2% for PASI 90, 50.8% and 48.8% for PASI 100, 82.1% and 83.0% for IGA score of 0/1, and 53.1% and 52.9% for IGA score of 0. Safety event rates of week 156 and week 100 were consistent.Guselkumab shows durable efficacy and a consistent safety profile in patients with moderate to severe psoriasis treated for up to 3 years.

韩国国家数据库资料示乌司奴单抗不增加结核风险。

概要：对韩国国家健康保险公司数据库（2012.1-2018.12）的分析显示，2803例接受乌司奴单抗治疗的患者与普通人群相比，其活动性结核标化发病率比为0.76。这说明，乌司奴单抗并不增加结核风险，提示即使在高疾病负担地区，使用乌司奴单抗治疗时也无需针对结核进行额外的监测。

A total of 2803 patients treated with UST were identified from the National Health Insurance Service database from January 2012 to December 2018. SIR was 0.76 compared to that in the general population. This study showed that UST did not increase the risk of TB compared to that among the general population in a real-world clinical setting in South Korea. These results suggest that UST treatment does not require additional TB monitoring even in areas with high disease burden.