Article(id=1292130344912834945, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1292130254689165893, articleNumber=null, orderNo=null, doi=10.13699/j.cnki.1001-6821.2026.05.004, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1750348800000, receivedDateStr=2025-06-20, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1785997480848, onlineDateStr=2026-08-06, pubDate=1773676800000, pubDateStr=2026-03-17, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1785997480848, onlineIssueDateStr=2026-08-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1785997480848, creator=13701087609, updateTime=1785997480848, updator=13701087609, issue=Issue{id=1292130254689165893, tenantId=1146029695717560320, journalId=1246415772164075586, year='2026', volume='42', issue='5', pageStart='601', pageEnd='750', issueExtLink='null', onlineDate='null', pubDate='1773676800000', pubDateStr='2026-03-17', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1785997459337, creator='13701087609', updateTime=1786014469153, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1292201599108141219, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1292130254689165893, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1292201599108141220, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1292130254689165893, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=619, endPage=624, ext={EN=ArticleExt(id=1292130345848164742, articleId=1292130344912834945, tenantId=1146029695717560320, journalId=1246415772164075586, language=EN, title=Clinical trial of tocilizumab combined with iguratimod in the treatment of elderly rheumatoid arthritis with interstitial pneumonia, columnId=1246531407326105792, journalTitle=Chinese Journal of Clinical Pharmacology, columnName=Clinical and Basic Bridging Research, runingTitle=null, highlight=null, articleAbstract=
Objective To observe the clinical efficacy and safety of tocilizumab injection combined with iguratimod tablets in the treatment of elderly patients with rheumatoid arthritis (RA) complicated with interstitial pneumonia.
Methods Elderly patients with RA complicated with interstitial pneumonia in our hospital were divided into control group and treatment group according to the treatment methods. The control group was given iguratimod tablets 25 mg bid, orally after breakfast and dinner, for a total of 12 weeks on the basis of the conventional treatment plan. The treatment group was given tocilizumab injection 8 mg·kg-1 intravenously every 4 weeks on the basis of control group. When abnormal liver enzymes, decreased neutrophil count, or decreased platelet count occurred, the dose of tocilizumab injection was reduced to 4 mg·kg-1, for a total of 12 weeks. The clinical efficacy, lung function and inflammatory response indicators of the two groups were compared, and the safety was evaluated.
Results A total of 84 cases were included in this study, with 39 cases in control group and 45 cases in treatment group. After treatment, the overall clinical response rates were 74.36% (29 cases /39 cases) in control group and 91.11% (41 cases /45 cases) in treatment group, respectively. The overall clinical response rate of treatment group was statistically significant higher than control group (P<0.05). After treatment, the levels of vital capacity (VC) in control group and treatment group were (2.25±0.34) and (2.38±0.30) L, respectively; the levels of forced expiratory volume in 1 second (FEV1) were (2.71±0.39) and (2.85±0.36) L, respectively; the high-resolution CT (HRCT) scores were (1.59±0.68) and (1.49±0.59) points, respectively. There was no statistically significant difference in the above indicators between the two groups (all P>0.05). After treatment, the levels of interleukin-6 (IL-6) in control group and treatment group were (13.27±1.95) and (12.05±1.72) pg·mL-1, respectively; the levels of rapid C-reactive protein (CRP) were (16.09±2.44) and (14.83±2.15) mg·L-1, respectively; the levels of matrix metalloproteinase-3 (MMP-3) were (60.32±9.59) and (55.61±8.27) μg·mL-1, respectively; the levels of tissue inhibitor of metalloproteinase-1 (TIMP-1) were (86.79±14.58) and (79.83±13.27) pg·mL-1, respectively. All the aforementioned indicators in treatment group were statistically significant lower than control group (P<0.05, P<0.01). The main adverse drug reactions in control group were elevated aminotransferase, leukopenia and upper abdominal pain. The main adverse drug reactions in treatment group were elevated aminotransferase, leukopenia, decreased neutrophil count and upper abdominal pain. The total incidence of adverse drug reactions was 7.69% in control group and 11.11% in treatment group, with no statistically significant difference (P>0.05).
Conclusion Tocilizumab injection combined with iguratimod tablets is effective in the treatment of elderly patients with RA complicated with interstitial pneumonia, and can effectively improve their clinical symptoms, serum marker levels, and lung function, reduce inflammatory responses, and has good safety.
, authors=Xiao-li ZHANG
1a, Yun-li REN
1a, Yan WANG
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目的 观察托珠单抗注射液联合艾拉莫德片治疗老年类风湿性关节炎（RA）合并间质性肺炎的临床疗效与安全性。
方法 将本院RA合并间质性肺炎老年患者根据治疗方法分为对照组与试验组。对照组在常规治疗方案基础上于早、晚餐后口服艾拉莫德片25 mg，bid，共用药12 w。试验组在对照组基础上静脉滴注8 mg·kg-1托珠单抗注射液，每4周1次，出现肝酶异常、中性粒细胞计数降低、血小板计数降低时，将托珠单抗注射液剂量减至4 mg·kg-1，共用药12 w。比较2组患者的临床疗效、肺功能和炎症反应指标，并进行安全性评价。
结果 本研究共纳入84例，对照组39例、试验组45例。治疗后，对照组和试验组的临床总有效率分别为74.36%（29例/39例）和91.11%（41例/45例），试验组显著高于对照组（P<0.05）。治疗后，对照组和试验组的肺活量（VC）水平分别为（2.25±0.34）和（2.38±0.30）L，第1秒用力呼气容积（FEV1）水平分别为（2.71±0.39）和（2.85±0.36）L，肺高分辨CT（HRCT）评分分别为（1.59±0.68）和（1.49±0.59）分，试验组的上述指标与对照组比较，在统计学上差异均无统计学意义（均P>0.05）。治疗后，对照组和试验组的白细胞介素-6（IL-6）水平分别为（13.27±1.95）和（12.05±1.72）pg·mL-1，快速C反应蛋白（CRP）水平分别为（16.09±2.44）和（14.83±2.15）mg·L-1，基质金属蛋白酶-3（MMP-3）水平分别为（60.32±9.59）和（55.61±8.27）μg·L-1，金属蛋白酶组织抑制因子-1（TIMP-1）水平分别为（86.79±14.58）和（79.83±13.27）pg·mL-1，试验组的上述指标均显著低于对照组（P<0.05，P<0.01）。对照组主要的药物不良反应有氨基转移酶升高、白细胞减少和上腹痛，试验组主要的药物不良反应有氨基转移酶升高、白细胞减少、中性粒细胞计数降低和上腹痛，对照组和实验组的药物不良反应总发生率分别为7.69%和11.11%，在统计学上差异无统计学意义（P>0.05）。
结论 托珠单抗注射液联合艾拉莫德片治疗老年RA合并间质性肺炎患者的疗效确切，能够有效改善其临床症状、血清标志物水平及肺功能，减轻炎症反应，并且安全性较好。
, authors=张小丽
1a, 任云丽
1a, 王妍
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张小丽（1983-），女，主治医师，主要从事类风湿关节炎方面的临床工作和研究
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