Department of Orthopedic Surgery, Nagoya University Hospital, Nagoya University, School of Medicine, 65 Tsurumai, Showa, Nagoya, Japan.
Mod Rheumatol. 2012 Jun;22(3):370-5. doi: 10.1007/s10165-011-0528-2. Epub 2011 Sep 20.
The goal of treating rheumatoid arthritis (RA) should be remission, for which a new definition was proposed in 2011. To determine which patients can achieve the new Boolean-based definition of remission in clinical practice, we analyzed factors associated with remission in 123 patients who received tocilizumab for 52 weeks. We found that patients with short disease duration (<4.8 years) had a significantly higher rate of remission (31.7%) than those with longer disease duration, and patient global assessment was the most important factor for achieving remission. Multivariate analysis revealed the following predictors of remission: short disease duration [<4.8 years; odds ratio (OR) 2.5, 95% confidence interval (CI) 1.4-4.7] and lower disease activity [28-joint disease activity score-erythrocyte sedimentation rate (DAS28-ESR) <5.23; OR 2.5, 95% CI 1.2-5.1). In this study, we showed that remission, as newly defined using a Boolean approach, is a realistic goal for patients treated with tocilizumab with short disease duration in real-world clinical practice.
治疗类风湿关节炎 (RA) 的目标应该是缓解,为此,2011 年提出了一个新的定义。为了确定在临床实践中哪些患者可以达到缓解的新布尔定义,我们分析了 123 例接受托珠单抗治疗 52 周的患者中与缓解相关的因素。我们发现,疾病持续时间较短(<4.8 年)的患者缓解率(31.7%)明显高于疾病持续时间较长的患者,患者的总体评估是实现缓解的最重要因素。多变量分析显示,缓解的预测因素包括:疾病持续时间较短(<4.8 年;比值比 [OR] 2.5,95%置信区间 [CI] 1.4-4.7)和疾病活动度较低[28 关节疾病活动评分-红细胞沉降率(DAS28-ESR)<5.23;OR 2.5,95%CI 1.2-5.1]。在这项研究中,我们表明,使用布尔方法新定义的缓解是现实的目标,对于在现实临床实践中接受托珠单抗治疗、疾病持续时间较短的患者来说是可以实现的。