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早期使用托珠单抗进行类风湿关节炎的积极干预可提高临床实践中基于布尔方法定义的缓解率。

Early aggressive intervention with tocilizumab for rheumatoid arthritis increases remission rate defined using a Boolean approach in clinical practice.

机构信息

Department of Orthopedic Surgery, Nagoya University Hospital, Nagoya University, School of Medicine, 65 Tsurumai, Showa, Nagoya, Japan.

出版信息

Mod Rheumatol. 2012 Jun;22(3):370-5. doi: 10.1007/s10165-011-0528-2. Epub 2011 Sep 20.

Abstract

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.

摘要

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。

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