?

Clin Rheumatol. 2010 May 5. [Epub ahead of print]

?????

Etanercept can induce resolution of renal deterioration in patients with amyloid A amyloidosis secondary to rheumatoid arthritis.

? ??????

Nakamura T, Higashi SI, Tomoda K, Tsukano M, Shono M.

????????

Section of Medicine and Rheumatology, Kumamoto Center for Arthritis and Rheumatology, 1-15-7 Kuhonji, Kumamoto, 862-0976, Japan, naktrkme@koh.marutakai.or.jp.

???????????

Abstract

?? ????????

The benefit of biological therapies in rheumatoid arthritis (RA) treatment is well known, but their role in amyloid A (AA) amyloidosis secondary to RA is unclear. The aim of this study was to clarify the clinical benefit of etanercept in RA patients with AA amyloidosis. We treated 14 RA patients who had serum amyloid A protein (SAA) 1.3 allele, with biopsy-confirmed AA amyloidosis with etanercept and investigated the efficacy of etanercept treatment, focusing on renal function retrospectively. The AA amyloidosis improved and stabilized after 89.1 +/- 27.2 weeks. Proteinuria decreased from 2.24 +/- 0.81 to 0.57 +/- 0.41 g/day (P < 0.01) and SAA fell from 250 +/- 129 to 26 +/- 15mug/ml (P < 0.01), respectively. Diarrhea secondary to gastrointestinal AA amyloidosis was less. Overall, the serum creatinine levels did not benefit with treatment, but in those with a creatinine values <2.0 mg/dl the creatinine level continued to fall (P = 0.021). Serum albumin increased following 96 weeks of etanercept treatment (P = 0.003). Etanercept treatment led to clinical improvement in proteinuria and serum albumin levels accompanied by a fall in SAA levels.

?

PMID: 20440529

依那西普诱导缓解RA继发性淀粉变性受累肾脏的受损肾功能

?

Nakamura T, et al.

Clin Rheumatol. 2010 May 5. 提前在线发表.

?????

生物制剂xxRA的疗效已为大家所熟知。但是目前尚不清楚它们对于RA继发性淀粉样蛋白A(AA)淀粉样变是否有xx作用。本研究将探明依那西普对于RA继发性AA淀粉样变是否有效。我们用依那西普xx了14例伴有AA淀粉样变的RA病人，他们均有血清淀粉样蛋白A(SAA)1.3等位基因，并经活检和病理检查证实为淀粉样变。我们研究了依那西普对这些病人的疗效，回顾性分析的重点是依那西普对这些病人肾脏的影响。经依那西普xx平均89.1 +/- 27.2周后，AA淀粉样变得到改善并稳定下来。蛋白尿从2.24 +/- 0.81克/天降至0.57 +/- 0.41克/天 (P < 0.01)，SAA从250 +/- 129 ug/mL降至26 +/- 15 ug/mL (P < 0.01)。继发于胃肠道AA淀粉样变的腹泻次数也减少了。总体而言，血清肌酐水平并没有因xx而获益，但那些肌酐水平<2.0 mg/dL的病人，他们的肌酐水平则继续下降(P = 0.021)。经过96周xx后，血清白蛋白水平升高(P = 0.003)。本研究证实依那西普可以改善AA淀粉样变所致蛋白尿以及血清白蛋白，同时降低SAA水平。