張貼者:大隆   張貼於2002/4/17 

蘋果AND大家好:
大隆哥哥又出現了, 前幾天我在美國的RA網站上看到一篇報導, (RA Information Netwrok), 有關MTX可降低心臟血管疾病的文章. 因為考慮到我們RA病友之家的眾家兄弟姊妹們的英文能力可能很X@&O%.......... (不服氣的人請拜託你們趕快努力學英文), 所以花了點時間將整篇文章翻成中文. 請蘋果先將本文及譯文轉給陳醫師看看. 個人建議將原文(英文)刊出. 至於翻譯的部分, 您及陳醫師可自行決定修改任何地方.

Rheumatoid Arthritis Drug Also Prolongs Life
Methotrexate found to have an added benefit
Web Posted:08-Apr-2002
By Adam Marcus HealthScoutNews Reporter


THURSDAY, April 4 (HealthScoutNews) -- People with rheumatoid arthritis who take methotrexate to ease their stiffness may be getting an additional benefit from the drug: longer life.
A new study shows that methotrexate cuts the overall risk of early death by 60 percent -- and slashes the odds of fatal heart and vessel illness by even more -- compared with not using the drug.
Although it’s not clear why, people with the joint ailment often suffer hardening of the arteries and cardiovascular disease. Methotrexate, which is also prescribed to treat certain cancers and to induce abortions, may control these problems enough to prevent their life-threatening complications like heart attacks and strokes, experts said. It may also simply improve symptoms enough to get people active and living healthier lifestyles, with a subsequent profit to longevity.
Dr. John H. Klippel, medical director of the Arthritis Foundation, called the new results "very important." "I think is just further evidence that [methotrexate] has effects that go well beyond improving joint inflammation and swelling," Klippel said. The findings are reported in the April 6 issue of The Lancet.
Methotrexate is the leading drug therapy for people with rheumatoid arthritis, a crippling autoimmune condition that affects more than 2 million Americans, roughly 60 percent of whom are women. The inflammatory disease typically sets in during middle age, striking joint lining and other tissue.
Over any 10-year period, people with rheumatoid arthritis have about twice the odds of dying -- usually succumbing to cardiovascular diseases and serious infections like pneumonia -- as those without the disorder. While low-dose methotrexate has been the standard of care for rheumatoid arthritis for a decade, doctors haven’t known if the drug saves lives. The latest work, the largest study yet to address the question, suggests the answer to that question is yes.
A team led by Dr. Frederick Wolfe, a University of Kansas joint specialist and director of the Arthritis Research Center Foundation in Wichita, followed 1,240 men and women with rheumatoid arthritis who’d sought treatment for their condition at a Wichita outpatient clinic. Beginning in 1981, roughly half the patients received methotrexate (many of those who didn’t enrolled in the study before the drug became a widespread treatment for arthritis). The rest were offered other arthritis treatments, such as non-steroidal anti-inflammatory drugs (NSAIDs).
People who got the more potent medication tended to have worse arthritis than the other patients. But even after adjusting for the severity of their disease, those on methotrexate were much more likely to be alive at the end of the study than those who didn’t receive the drug. Of the 191 deaths that occurred among the subjects between 1981 and 1999, 72 were in the methotrexate group vs. 119 among the rest of the patients.
The bulk of methotrexate’s protective effect appeared to be its ability to reduce the risk of deadly cardiovascular complications, which were 70 percent less likely in people who received the drug. But it also cut the odds of dying from infections, too.
Other arthritis treatments may offer short-term relief, but Wolfe said the long-term survival benefit from methotrexate "sets the standard for what we should be aiming for."
Methotrexate is considered generally safe. However, it can in rare cases lead to serious side effects that include liver disease, lung injury and even certain cancers.

治療RA的藥物也可以延長壽命
Methotrexate(以下簡稱MTX)有附加的效益
記者: Adam Marcus / 健康搜尋新聞

星期四, 四月四日(健康搜尋新聞) –- 服用MTX來減緩RA患者的(關節)僵硬, MTX或許有一個附加的好處: 延長壽命.
一份最新的研究報告顯示, MTX可降低一般死亡率的成效達60%, 而且和沒使用MTX的患者相比較, MTX降低致命性的心臟及血管疾病 之成效更高.
專家表示, 儘管原因不清楚,患有關節方面疾病的人通常也受苦於動脈硬化或心血管方面的疾病. MTX有時也被用來治療某些癌症及引導流產, 但卻也能相當程度的避免心臟病及中風. MTX能改善(風濕)症狀並且讓病患處於更健康及活躍的狀態, 進而有延長壽命的益處.
John H. Klippel醫師, 關節基金會的醫學總監, 表示此項發現”非常的重要”. “我認為進一步的證據顯示MTX的功效還不只於改善關節的腫痛問題而已”. 這項發現報導在四月六日的”手術刀”雜誌中.
MTX是RA的主要處方藥, (RA)源自因缺陷的自體免疫系統問題而影響超過二百萬美國人, 大約60%患者為女性. 好發於中層年紀的人, 攻擊關節及其他組織.
超過 10年前, 和沒有RA的患者相比較, RA患者的死亡因素, 有二倍以上的機率是因為心血管疾病及如肺炎等嚴重的感染. 但是這十年來, 低劑量的MTX已廣泛被用為治療RA的標準處方, 醫生們仍然不知道是否MTX能救人一命, 但是在最近這段期間針對這個問題的大量研究中, 答案傾向於是肯定的.
一組由Frederick Wolfe博士率領的團隊, 由堪薩斯大學的關節專家及Wichita關節研究基金會的會員組成, 以1240名RA男女患者配合治療. 從1981年起, 大約一半的患者接受MTX的處方(這些患者在服用MTX的當時尚未參與本項研究). 其餘的患者則使用其他的關節治療處方, 例如非類固醇性的抗腫藥物.
關節問題較嚴重的人使用的劑量也較強. 但儘管依每個人的個別症狀嚴重程度不同而調整用藥劑量, 在這份研究結束的時候, 服用MTX而仍然活著的人似乎比沒服用MTX的人還多. 研究期間從1981年起到1999年止, (1240名參予研究的RA患者中)有191名死亡, 其中72名服用MTX, 其他119名則沒服用MTX.
在服用MTX的組群中, MTX的保護效應顯示在其降低心臟血管疾病及其併發症的死亡機率, 成效達70%上下. 研究中也發現MTX亦能降低因感染而死亡的機率.
其他的治療方式亦提供了關節上短期的紓解, 但Wolfe博士表示MTX的長期功效讓他們(譯註:”他們”指的是Wolfe博士的研究團隊)設定了(更高的)研究標準.
MTX一般被認為是安全的, 但是, MTX在極少數的個案中也導致嚴重的副作用, 例如肝方面的疾病, 肺傷害, 甚至某些癌症.

 



回應者:蘋果  張貼於2002/4/17 【第 1 篇回應】

除了感謝之外,真不知道該說什麼,大隆兄.......偶像@@...



回應者:陳醫師  張貼於2002/4/18 【第 2 篇回應】

除了一些小缺點外,翻譯內容是大致正確的,這篇研究結果我們臨床上也有相同的經驗,我想不只是MTX這種藥物而已,其他的免疫調整劑也有相同的作用,只要將全身發炎狀況控制穩定的話,心臟血管疾病的發生比例,就會降低,所以隨著醫學的進展,RA並不會比正常人的壽命短,所以大家要接受正確治療將病情控制穩定喔!



回應者:蘋果   張貼於2002/4/18 【第 3 篇回應】

感謝帥爸百忙之中來作註解!
經過帥爸的解釋之後.......大家能有更正確的認知!!^@^

感謝帥爸.....感謝大隆哥哥!^^

 

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