Background. Influence of iguratimod on bone mineral density (BMD) and biomarkers of bone metabolism in patients with rheumatoid arthritis (RA) remains not determined. Accordingly, a meta-analysis was performed for systematical evaluation. Methods. Relevant randomized controlled trials (RCTs) were retrieved by searching of PubMed, Embase, Cochrane’s Library, China National Knowledge Infrastructure (CNKI), and Wanfang databases. A random-effect model was used to pool the results. Results. In total, 24 RCTs including 2439 patients with RA contributed to the meta-analysis. Pooled results showed that compared to methotrexate alone, additional use of iguratimod 25 mg Bid for 12∼24 weeks significantly improved lumbar-spine BMD (mean difference [MD]: 0.12, 95% confidence interval [CI]: 0.04 to 0.20, p = 0.002 , I2 = 39%) in patients with RA. Moreover, treatment with iguratimod was associated with increased serum osteoprotegerin (MD: 180.36 pg/ml, 95% CI: 122.52 to 238.20, p < 0.001 , I2 = 48%), and decreased serum receptor activator for nuclear factor kappa-B ligand (MD: −10.65 pmol/l, 95% CI: −15.59 to −5.72, p < 0.001 , I2 = 53%). In addition, iguratimod was associated with increased bone formation markers such as the serum N-terminal middle molecular fragment of osteocalcin (MD: 4.23 ng/ml, 95% CI: 3.74 to 4.71, p < 0.001 , I2 = 35%) and total procollagen type I amino-terminal propeptide (MD: 9.10 ng/ml, 95% CI: 7.39 to 10.80, p < 0.001 , I2 = 86%), but decreased the bone resorption marker such as serum β-C terminal cross-linking telopeptide of type 1 collagen (MD: −0.18 pg/ml, 95% CI: −0.21 to −0.14, p < 0.001 , I2 = 70%). Conclusions. Iguratimod could prevent the bone loss and improve the bone metabolism in patients with RA.
Background: This study aimed to evaluate the cost-effectiveness of Anbainuo (ABN) plus methotrexate (MTX) vs. conventional disease-modifying antirheumatic drugs (cDMARDs) in Chinese rheumatoid arthritis (RA) patients.Methods: A total of 90 RA patients who underwent ABN + MTX [assigned as ABN + MTX group (n=47)] or cDMARDs [assigned as control group (n=43)] treatment were analyzed. Disease activity was assessed at baseline (M0), 3 rd month (M3), 6 th month (M6), and 12 th month (M12) after treatment. Drug, other medical, indirect, and total costs were calculated. Then, pharmacoeconomic analyses were performed with the threshold of cost-effectiveness set as 3 times of the mean gross domestic product (GDP) per capita in China during the study period.Results: Treatment response rate was similar between the 2 groups, while disease remission and low disease activity (LDA) rates were increased in the ABN + MTX group compared to control group. Drug cost, other medical costs, and total cost were higher in the ABN + MTX group than control group, while indirect cost was similar between the 2 groups. Meanwhile, the quality-adjusted life-years (QALY) in ABN + MTX group and control group were 0.72 and 0.48 years, respectively. The incremental cost-effectiveness ratios (ICER) of ABN + MTX group compared to control group among the entire participant cohort, moderate-diseaseactivity participants, and severe-disease-activity participants were ¥135,486.7, ¥146,450.4, and ¥124,987.2/ QALY, respectively, which were all below the cost-effectiveness threshold. Further sensitivity analyses revealed that the cost-effectiveness of ABN + MTX vs. cDMARDs was relatively robust, while among all the indexes, ABN price and Health Assessment Questionnaire Disability Index (HAQ-DI) score change for the ABN + MTX group affected ICER most.Conclusions: Treatment with ABN + MTX offers acceptable cost-effectiveness compared to cDMARDs treatment in Chinese RA patients.
The rapid development of the economy has made the scarcity of traditional fossil energy increasingly prominent. At the same time, with the proposal of the beautiful China strategy, electric vehicles have become an important choice for people to travel. Different charging and discharging modes of electric vehicles have different impacts on the power grid load production. Reasonably controlling the impact of electric vehicle charging and discharging loads on the power grid, narrowing the peak-to-valley difference, and ensuring the reliability of grid operation have become urgent issues to be resolved. This paper selects electric private cars and electric buses that have a large effect on the power grid load as the research object, and uses qualitative and quantitative research methods to extract the main influencing factors of electric vehicle charge and discharge. A charge and discharge daily load calculation model for electric vehicles under three modes of disorderly charging, one-way ordered charging and bidirectional ordered charging and discharging was constructed, and a typical Tianjin electric vehicle charging behavior research sample was selected. Monte Carlo method was used to predict the daily load of Tianjin electric vehicles under three charging and discharging modes, and the results were analyzed and discussed, and the corresponding management inspiration was given.
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