Reneses Sonsoles, Fernández-Suárez Antonio, González-Escribano Maria F, Pestana Luis, García Alicia
Department of Rheumatology, Virgen del Rocío University Hospital, 41013 Seville, Spain.
ISRN Rheumatol. 2011;2011:780356. doi: 10.5402/2011/780356. Epub 2011 Aug 8.
We assessed the contribution of four baseline markers-HLA-DRB1 shared epitope (SE), -308 tumor necrosis factor α gene promoter polymorphism, rheumatoid factor, and anticitrullinated peptide antibodies-for predicting persistent activity (DAS28 score ≥2.6) after one year of followup in a cohort of 201 patients with recent-onset rheumatoid arthritis (RA) or undifferentiated arthritis (UA) aged 16 years or older who had a 4-week to 12-month history of swelling of at least two joints. Patients had not been previously treated with corticosteroids or disease-modifying antirheumatic drugs (DMARD). In the best logistic regression model, only two variables were retained: SE positivity and number of DMARD administered (area under the curve = 76.4%; 95% CI: 69.2%, 84.4%; P < 0.001). The best linear regression model also included these two variables, explaining only 22.5% of the variability of DAS28 score. In this study, given an equal number of DMARD administered, the probability of persistent activity in patients with recent-onset RA or UA was significantly influenced by SE presence.
我们评估了四个基线标志物——HLA - DRB1共享表位（SE）、肿瘤坏死因子α基因启动子 - 308多态性、类风湿因子和抗瓜氨酸化肽抗体——对一组201例年龄在16岁及以上的近期发病类风湿关节炎（RA）或未分化关节炎（UA）患者随访一年后持续活动（疾病活动度评分（DAS28）≥2.6）的预测作用。这些患者至少两个关节肿胀病史为4周-12个月，此前未接受过皮质类固醇或改善病情抗风湿药物（DMARD）治疗。在最佳逻辑回归模型中，仅保留了两个变量：SE阳性和DMARD给药数量（曲线下面积 = 76.4%；95%置信区间：69.2%，84.4%；P < 0.001）。最佳线性回归模型也包含这两个变量，仅解释了DAS28评分变异性的22.5%。在本研究中，在DMARD给药数量相同的情况下，近期发病的RA或UA患者持续活动的概率受SE存在情况的显著影响。
