Clinical efficacy of methotrexate and tofacitinib combined with tripterygium wilfordii polyglycosides in treatment of rheumatoid arthritis
Wang Ying
Dong Xin
Zhao Xiang-zhuo
Wang Jing-xu
Zhu Xiao-li
Abstract：Objective To evaluate the clinical efficacy of methotrexate and tofacitinib combined with tripterygium wilfor-dii polyglycosides in the treatment of rheumatoid arthritis. Methods A total of 112 patients with rheumatoid arthritis admitted to Xingtai First Hospital from August 2022 to June 2024 were selected and divided into an observation group and a control group according to the random number table method,with 56 in each group. The patients in the control group took methotrexate (10 mg/time,once a week) and tripterygium wilfordii polyglycosides tablets (two tablets/time,three times a day),and those in the observa-tion group took tofacitinib citrate tablets (one tablet/time,twice a day) based on the regimen in the control group. All the patients in both groups received treatment for 3 months. The clinical efficacy,clinical symptom improvement time,serum immune factor (immunoglobulin G (IgG),immunoglobulin M (IgM),rheumatoid factor (RF)) levels before and after treatment,inflammatory factor (erythrocyte sedimentation rate (ESR),high-sensitivity C-reactive protein (hs-CRP),interleukin-6 (IL-6),tumor necrosis factor-α(TNF-α)) levels,bone metabolism index (serum bone alkaline phosphatase (B-ALP),type I procollagen carboxyl-terminal propeptide content (PICP) and osteocalcin (BGP)) levels,and adverse reactions during treatment were determined and compared between the two groups. Results After treatment,the total effective rate in the observation group was 96.43％ (54/56),which was higher than that of 85.71％ (48/56)) in the control (x2=4.846,P<0.05). The duration of morning stiffness,number of joint swelling and tender-ness in the observation group ((28.73±5.72) min,(5.33±1.45) joints,(6.64±1.59) joints) were significantly lower than those in the control ((37.05±6.39) min,(7.82±1.76) joints,8.90±1.85 joints) (t=7.259,8.171,6.933,all P<0.001). The levels of immune factors IgG,IgM and RF were significantly decreased after treatment,and their levels in the observation group ((9.67±2.48) g·L-1,(1.41±0.25) g·L-1,(70.63±20.24) U·mL-1) were significantly lower than those in the control ((10.91±3.02) g·L-1,(1.56±0.44) g·L-1,(79.55±23.74) U·mL-1) (t=2.375,2.218,2.140,all P<0.05). The levels of serum inflammatory factors ESR,CRP,IL-6 and TNF-α were decreased significantly after treatment,and their levels in the observation group ((26.62±5.35) mm·h-1,(7.43±1.95) mg·L-1,(9.48±2.71) ng·mL-1,(26.32±5.22) ng·L-1) were significantly lower than those in the control ((34.38±6.04) mm·h-1,(11.72±2.83) mg·L-1,(14.42±3.17) ng·mL-1,(33.47±6.51) ng·L-1) (t=7.197,9.341,8.864,6.412,all P<0.001). The level of bone metabolism index B-ALP was significantly decreased,and it was was lower in the observation group than in the control ((20.48±2.62) U·L-1 vs (26.55±3.12) U·L-1) (t=11.149,P<0.001). The PICP and BGP levels were increased,and their levels in the observation group ((47.74±5.66) ng·mL-1,(27.68±3.54) ng·mL-1) were higher than those in the control ((41.52±5.43) ng·mL-1,(23.91±3.42) ng·mL-1)(t=5.934,5.732,both P<0.001). There were 4 cases (7.13％) found to have adverse reactions in the observation group and 5 cases (8.91％) in the control,showing no significant difference (x2=0.000,P>0.05). Conclusion Methotrexate and tofacitinib combined with tripterygium wilfordii polyglycosides has good clinical efficacy in the treatment of rheumatoid arthritis since it can relieve morning stiffness,joint swelling and pain,regulate the body's immunity,reduce the level of inflammatory factors in patients and promote the function of osteoblasts.
Keywords：Rheumatoid arthritisMethotrexateTofacitinibTripterygium wilfordii polyglycoside tabletImmune functionInflammatory factorOsteoblast
Publication Date：2024-12-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 826-831 )