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在两项阿巴西普临床试验中,仅采用患者报告的结局指标的一个指数——患者指数数据3常规评估(RAPID3):结果与疾病活动评分(DAS28)以及其他包含医生报告指标的RAPID指数相似。

An index of only patient-reported outcome measures, routine assessment of patient index data 3 (RAPID3), in two abatacept clinical trials: similar results to disease activity score (DAS28) and other RAPID indices that include physician-reported measures.

作者信息

Pincus T, Bergman M J, Yazici Y, Hines P, Raghupathi K, Maclean R

机构信息

NYU Hospital for Joint Diseases, 301 East 17th Street, New York, NY 10003, USA.

出版信息

Rheumatology (Oxford). 2008 Mar;47(3):345-9. doi: 10.1093/rheumatology/kem364. Epub 2008 Jan 31.

Abstract

OBJECTIVES

To analyse the capacity of routine assessment of patient index data 3 (RAPID3), an index of only the three patient-reported outcome (PRO) measures in the RA Core Data Set-physical function, pain and global status-to distinguish abatacept from control treatments in two clinical trials, and to compare RAPID3 results with the disease activity score 28 (DAS28) and RAPID-based indices that add a tender or swollen joint count and/or physician/assessor global estimate of status.

METHODS

Clinical trial data from AIM (Abatacept in Inadequate response to Methotrexate) and ATTAIN [Abatacept Trial in Treatment of Anti-tumor necrosis factor (anti-TNF) INadequate responders] were reanalysed. Mean values were computed at baseline, endpoint and for change between baseline and endpoint for RAPID3, DAS28 and additional RAPID indices to study whether they had greater capacity to distinguish abatacept from control therapy. RAPID4TJC adds to RAPID3 a tender joint count; RAPID4SJC, a swollen joint count; RAPID4MD, a physician/assessor global estimate; and RAPID5 adds both a tender joint count and physician/assessor global estimate. RAPID2 includes only physician/assessor and patient global estimates.

RESULTS

All indices indicated significant differences of 19-28% between abatacept and control groups. Results were similar for RAPID3 of only patient measures, compared to DAS28 and other RAPID-based indices.

CONCLUSION

A RAPID3 'patient-only' index, without a joint count or any measure from a health professional or laboratory, distinguishes active from control treatments in two abatacept clinical trials, at levels similar to DAS28 and to other RAPID-based indices that add physician-reported measures.

摘要

目的

分析患者指数数据3(RAPID3)的常规评估能力,RAPID3是类风湿关节炎核心数据集中仅有的三项患者报告结局(PRO)指标——身体功能、疼痛和整体状况,以在两项临床试验中区分阿巴西普与对照治疗,并将RAPID3结果与疾病活动评分28(DAS28)以及添加压痛或肿胀关节计数和/或医生/评估者整体状况评估的基于RAPID的指标进行比较。

方法

对来自AIM(甲氨蝶呤反应不足时使用阿巴西普)和ATTAIN[抗肿瘤坏死因子(抗TNF)反应不足者的阿巴西普试验]的临床试验数据进行重新分析。计算RAPID3、DAS28和其他RAPID指标在基线、终点以及基线与终点之间变化的平均值,以研究它们区分阿巴西普与对照治疗的能力是否更强。RAPID4TJC在RAPID3基础上增加了压痛关节计数;RAPID4SJC增加了肿胀关节计数;RAPID4MD增加了医生/评估者整体状况评估;RAPID5同时增加了压痛关节计数和医生/评估者整体状况评估。RAPID2仅包括医生/评估者和患者的整体状况评估。

结果

所有指标均显示阿巴西普组与对照组之间存在19%至28%的显著差异。仅包含患者指标的RAPID3的结果,与DAS28和其他基于RAPID的指标相似。

结论

在两项阿巴西普临床试验中,仅包含患者指标、无关节计数或任何来自医疗专业人员或实验室测量值的RAPID3指标,区分活性治疗与对照治疗的能力与DAS28以及添加医生报告指标的其他基于RAPID的指标相当。

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