Division of Rheumatology, Department of Internal Medicine 3, Medical University Vienna, 1090 Vienna, Austria.
Ann Rheum Dis. 2012 Oct;71(10):1702-5. doi: 10.1136/annrheumdis-2012-201519. Epub 2012 Jun 26.
The American College of Rheumatology/European League Against Rheumatism remission criteria for rheumatoid arthritis (RA) have been published recently.
To quantify the proportions of patients fulfilling only three of the four Boolean criteria and the relevance of patient global assessment (PGA) in context of remission.
From an observational prospective RA database the first visit of patients, fulfilling just three of the four Boolean criteria was identified. Logistic regression and descriptive analyses were processed, also defining remission by index-based (Simplified Disease Activity Index (SDAI)) definition and comparing outcomes with the evaluator global assessment (EGA).
52% had at least one visit, fulfilling just three criteria (not fulfilled were: PGA 61%; swollen joints 20%; tender joints 13%; C-reactive-protein 7%). 67% of patients not fulfilling the PGA criterion had an EGA≤1 cm, 25% of those fulfilled the SDAI definition. Increased pain (OR=1.28), EGA (OR=1.10) and discrepancy towards higher PGA than EGA (OR=1.28) could explain PGA failure to reach remission.
PGA is often the limiting factor for reaching remission; index-based remission showed balancing effects by adjusting for elevated variables in the summative score.
美国风湿病学会/欧洲抗风湿病联盟最近发布了类风湿关节炎（RA）的缓解标准。
量化仅满足四个布尔标准中的三个的患者比例，以及患者整体评估（PGA）在缓解背景下的相关性。
从一个观察性前瞻性 RA 数据库中，确定了首次就诊时仅满足四个布尔标准中的三个的患者。进行了逻辑回归和描述性分析，还通过基于指数的（简化疾病活动指数（SDAI））定义来定义缓解，并将结果与评估者整体评估（EGA）进行比较。
52%的患者至少有一次就诊，仅满足三个标准（未满足的标准为：PGA 61%；肿胀关节 20%；压痛关节 13%；C 反应蛋白 7%）。67%未满足 PGA 标准的患者 EGA≤1cm，25%的患者符合 SDAI 定义。疼痛增加（OR=1.28）、EGA（OR=1.10）和 PGA 高于 EGA 的差异（OR=1.28）可以解释 PGA 未能达到缓解的原因。
PGA 通常是达到缓解的限制因素；基于指数的缓解通过调整综合评分中的升高变量来达到平衡效果。
