Gülfe Anders, Kristensen Lars Erik, Geborek Pierre
Department of Rheumatology, Lund University Hospital, SE-221 85 Lund, Sweden.
J Rheumatol. 2009 Mar;36(3):517-21. doi: 10.3899/jrheum.080509. Epub 2009 Jan 22.
To investigate if treatment response predicts continuation of anti-tumor necrosis factor (TNF) treatment in patients with rheumatoid arthritis (RA).
We investigated if treatment response and/or achieving a certain activity state at 6 weeks or 3 months predicts continuation of treatment in an observational cohort of 1789 anti-TNF-naive patients with established RA disease from southern Sweden.
Response to treatment at 6 weeks at overall/American College of Rheumatology (ACR20) or good/major level (except ACR70) significantly predicted drug continuation. Response according to all criteria sets at overall/ACR20 and at good/major/ACR70 level predicted drug continuation at 3 months, as did achieving low disease activity at 3 months irrespective of activity index applied. Remaining in a high disease activity state predicted drug discontinuation at both timepoints and according to all criteria sets.
Response criteria may be useful aids in deciding on continuation of TNF blockade in RA as early as after 6 weeks of treatment. The various criteria sets perform similarly.
探讨治疗反应是否可预测类风湿关节炎（RA）患者抗肿瘤坏死因子（TNF）治疗的持续情况。
我们在一个来自瑞典南部的1789例初治抗TNF的确诊RA患者的观察队列中，研究6周或3个月时的治疗反应和/或达到某种活动状态是否可预测治疗的持续情况。
6周时总体/美国风湿病学会（ACR20）或良好/主要水平（ACR70除外）的治疗反应显著预测了药物的持续使用。根据所有标准集在总体/ACR20以及良好/主要/ACR70水平的反应预测了3个月时药物的持续使用，3个月时达到低疾病活动度也预测了药物的持续使用，而不论使用何种活动指数。处于高疾病活动状态预测了两个时间点以及所有标准集下的药物停用。
反应标准可能有助于早在治疗6周后就决定RA患者是否继续TNF阻断治疗。各种标准集的表现相似。
