在 ESPOIR 队列纳入后 1 年达到 SDAI 缓解与低疾病活动度与更好的 3 年结构结局相关。
Aiming for SDAI remission versus low disease activity at 1 year after inclusion in ESPOIR cohort is associated with better 3-year structural outcomes.
机构信息
UMR 1027, INSERM, Toulouse, France UMR 1027, University Paul Sabatier Toulouse III, Toulouse, France Rheumatology Center, Purpan Hospital, Toulouse, France.
UMR 1027, INSERM, Toulouse, France UMR 1027, University Paul Sabatier Toulouse III, Toulouse, France.
出版信息
Ann Rheum Dis. 2015 Sep;74(9):1676-83. doi: 10.1136/annrheumdis-2013-204906. Epub 2014 May 2.
OBJECTIVES
Using data for patients with early rheumatoid arthritis (RA) from the ESPOIR cohort, we aimed to evaluate the impact of remission versus low disease activity (LDA) by the Simple Disease Activity Index (SDAI) at 1 year on 3-year structural damage assessed by the modified Sharp-van der Heijde total score (mTSS) and functional impairment assessed by the Health Assessment Questionnaire Disability Index (HAQ-DI).
METHODS
We included 625 patients from the ESPOIR cohort who fulfilled the 2010 American College of Rheumatology/European League Against Rheumatism criteria for RA at baseline and had an SDAI score at 1 year. mTSS and HAQ-DI scores were compared at 3 years for patients with SDAI remission or LDA status at 1 year. A linear mixed model was used to assess the independent effect of SDAI status at 1 year on mTSS and HAQ-DI at 3 years.
RESULTS
Of the 625 patients included (mean (SD) age 48.5 (12.1) years; 491 (78.6%) were women), 121 (19.4%) were in SDAI remission and 223 (35.7%) in LDA at 1 year. The mean (SD) mTSS and HAQ-DI score at 3 years was 9.6 (9.2) and 0.23 (0.42), respectively, for patients in remission at 1 year and 15.8 (16.1) and 0.43 (0.52), respectively, for patients with LDA (both p<0.05). Multivariate analysis revealed an association of remission rather than LDA status at 1 year and reduced mTSS score (p=0.005) but not HAQ-DI score (p=0.4) at 3 years.
CONCLUSIONS
Aiming for SDAI remission rather than LDA at 1 year leads to better radiographic outcomes at 3 years in early RA patients.
目的
利用 ESPOIR 队列中早期类风湿关节炎（RA）患者的数据，我们旨在通过简单疾病活动指数（SDAI）评估 1 年时缓解与低疾病活动度（LDA）对改良 Sharp-van der Heijde 总评分（mTSS）评估的 3 年结构损伤和健康评估问卷残疾指数（HAQ-DI）评估的功能障碍的影响。
方法
我们纳入了基线时符合 2010 年美国风湿病学会/欧洲抗风湿病联盟 RA 标准且 1 年时 SDAI 评分可评估的 625 名 ESPOIR 队列患者。对 1 年时 SDAI 缓解或 LDA 状态的患者，在 3 年时比较 mTSS 和 HAQ-DI 评分。采用线性混合模型评估 1 年时 SDAI 状态对 3 年时 mTSS 和 HAQ-DI 的独立影响。
结果
在纳入的 625 名患者中（平均（标准差）年龄 48.5（12.1）岁；491 名[78.6%]为女性），121 名（19.4%）在 1 年时达到 SDAI 缓解，223 名（35.7%）达到 LDA。在 1 年时缓解的患者中，3 年时 mTSS 和 HAQ-DI 评分的平均值（标准差）分别为 9.6（9.2）和 0.23（0.42），而在 LDA 的患者中分别为 15.8（16.1）和 0.43（0.52）（均 p<0.05）。多变量分析显示，1 年时缓解而非 LDA 状态与 mTSS 评分降低相关（p=0.005），但与 HAQ-DI 评分无关（p=0.4）。
结论
在早期 RA 患者中，1 年时目标为 SDAI 缓解而非 LDA 可导致 3 年时影像学结局更好。
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