艾拉莫德与甲氨蝶呤联用对老年类风湿关节炎的临床疗效OA

AIM To explore the clinical efficacy of the combination of iguratimod and methotrexate in rheumatoid arthritis(RA)in the elderly.METHODS A total of 80 elderly patients with RA admitted to the hospital from October 2022 to October 2024 were selected.They were divided into a control group(40 patients)and an observation group(40 patients)according to the treatment method.The control group was treated with methotrexate tablets,while the observation group was treated with iguratimod combined with methotrexate.Both groups were treated for 6 months.The clinical efficacy,symptom improvement,bone mineral density,bone metabolism,levels of inflammatory factors,and adverse reactions were compared between 2 groups.RESULTS After 6 months of treatment,the rates of American College of Rheumatology(ACR)20％remission and ACR 50％remission were higher in the observation group than those in the control group.Differences in the visual analogue scale(VAS),patient's global assessment of disease activity(PtGA),physician's global assessment of disease activity(PhGA)and health assessment questionnaire(HAQ)scores were greater than those in the control group,and the differences were statistically significant(P＜0.05).After 3 and 6 months of treatment,the duration of morning stiffness in the observation group was shorter.Tender joint count,swelling joint count,and disease activity score in 28 joints(DAS28 score)in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P＜0.05).After 6 months of treatment,the levels of rheumatoid factor(RF),C-reactive protein(CRP),interleukin-6(IL-6),interleukin-8(IL-8)and beta-collagen degradation product(β-CTX)in the observation group were significantly lower than those in the control group.The improvements in bone mineral density of thoracolumbar spine,hip joint,femoral neck and greater trochanter,skeletal muscle mass index,and the levels of bone Gla protein(BGP),total procollagen Ⅰ N-terminal propeptide(P Ⅰ NP)and 25 hydroxyvitamin D[25(OH)D]were greater in the observation group,with statistically significant differences(P＜0.05).Adverse reactions in both groups were mild,with no statistically significant differences in the incidence of adverse reactions(P＞0.05).CONCLUSION The combination of iguratimod and methotrexate can improve the therapeutic effect on RA in the elderly,alleviate RA symptoms and improve bone metabolism indicators,with a good safety profile.