Paulus H E, Egger M J, Ward J R, Williams H J
Division of Rheumatology, University of California, Los Angeles School of Medicine 90024-1670.
Arthritis Rheum. 1990 Apr;33(4):477-84. doi: 10.1002/art.1780330403.
A composite index for estimating improvement in individual rheumatoid arthritis (RA) patients during trials of slow-acting, disease-modifying antirheumatic drugs (DMARDs) was developed by analyzing the responses of 130 placebo-treated participants in Cooperative Systematic Studies of Rheumatic Diseases studies. If responses in 4 of 6 selected measures were required for improvement (by greater than or equal to 20% for morning stiffness, Westergren erythrocyte sedimentation rate, joint pain/tenderness score, and joint swelling score, and by greater than or equal to 2 grades on a 5-grade scale, or from grade 2 to grade 1 for patient's and physician's overall assessments of current disease severity), few placebo-treated patients qualified as improved, whereas significantly more DMARD-treated patients demonstrated improvement. The proposed index appears to be useful in estimating the probability that an RA patient will improve if taking a placebo during a DMARD trial, and may be a useful tool for analysis of DMARD studies.
通过分析风湿性疾病合作系统研究中130名接受安慰剂治疗参与者的反应，开发了一种用于评估单个类风湿性关节炎（RA）患者在使用慢作用抗风湿药物（DMARDs）进行试验期间病情改善情况的综合指数。若改善需要6项选定指标中的4项出现反应（晨僵、魏氏血沉、关节疼痛/压痛评分和关节肿胀评分改善大于或等于20%，5级量表上改善大于或等于2级，或患者和医生对当前疾病严重程度的总体评估从2级降至1级），则很少有接受安慰剂治疗的患者符合改善标准，而接受DMARD治疗的患者改善的比例显著更高。所提出的指数似乎有助于评估RA患者在DMARD试验中服用安慰剂时病情改善的可能性，并且可能是分析DMARD研究的有用工具。
