课件：常见风湿病治疗药物及误区.ppt

UsPA 治疗 杨XX，男，42岁，腰背部间隙性疼痛发作11年，活动后减轻，NSAID有效，有时能自动缓解。有过膝关节疼痛。辅助检查：脊柱四肢活动正常，ESR和CRP正常，HLA-B27（+），脊柱X无异常，骶髂关节CT示局限性硬化，无破坏，关节间隙正常，此次发作就诊如何选择治疗方案？ 1.一种NSAID 2.NSAID+MTX 3.NSAID+MTX+SASP 4.NSAID+SASP 5.NSAID+反应停 6.P+来复米特+SASP 其他 PSS SSc Go Through Three Centuries Create One Hundred Year Resplendence 谢 谢！ 后面内容直接删除就行 资料可以编辑修改使用 资料可以编辑修改使用 资料仅供参考，实际情况实际分析 主要经营：课件设计，文档制作，网络软件设计、图文设计制作、发布广告等 秉着以优质的服务对待每一位客户，做到让客户满意！ 致力于数据挖掘，合同简历、论文写作、PPT设计、计划书、策划案、学习课件、各类模板等方方面面，打造全网一站式需求 * * * * * * * Slide 38. Phase III REFLEX Study Now I fail a TNF, what does it look like? And the answer is, that’s amazing. We had 50-20-10, now we have 51-27-12 -- that’s unbelievable. They look alike. You went from 55-30-20 to 50-27-12, and you say, that doesn’t look very good. The deltas, the difference, is the same ACR 20s, the ACR 50 deltas again look like the pre-TNF, it’s the ACR 70s that are significantly lower. Again, two thirds less ACR 70s after TNF than before. Because remember, the placebo responses drop after you fail a TNF compared to before. So they do respond, but you lose the high-end responses. * * Slide 36. Phase III ATTAIN Study One, we’re using abatacept, it’s a T-cell inhibitor, and the question is, if I fail a TNF blocker, and I then go into the ATTAIN trial, remember, you fail a TNF and then you use abatacept in combination with methotrexate, how do I do? Do I do worse after I fail a TNF than before? Let me remind you, the ACR 20-50-70 in the AIM trial, that is, before you fail a TNF, is 74-50-30. Now I failed the TNF, and I go onto abatacept. The results are here. Its now 50-20-10. Failing a TNF, you’re not doing as well. 50-20-10 is much lower than 74-50-30. The placebos are much lower if you fail a TNF. If you look at the deltas, the difference between the active agent and placebo, the ACR 20s are the same, the ACR 50s are a little lower, but the ACR 70s are substantially lower. So you lose about two thirds of the ACR 70 response. Only about a third of patients do as wel