澳大利亚OPAL队列中的类风湿性关节炎患者在5年期间疾病活动度有显著改善：一项多中心观察性研究。
Patients with Rheumatoid Arthritis in the Australian OPAL Cohort Show Significant Improvement in Disease Activity over 5 Years: A Multicenter Observational Study.
作者信息
Littlejohn Geoffrey, Roberts Lynden, Bird Paul, de Jager Julien, Griffiths Hedley, Nicholls Dave, Young Jennifer, Zochling Jane, Tymms Kathleen E
机构信息
From Monash University, Clayton; James Cook University, Douglas; Combined Rheumatology Practice, Sydney; Gold Coast Rheumatology, Southport; Barwon Rheumatology Service, Geelong; Coast Joint Care, Maroochydore; Roche Products Propriety Limited, Dee Why; Menzies Research Institute Tasmania, Hobart; Canberra Rheumatology, Canberra, Australia.G. Littlejohn, MD, MPH, MBBS, FRACP, Professor of Medicine, Monash University; L. Roberts, MBBS, PhD, FRACP, Associate Professor of Medicine, Monash University and James Cook University; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip (MRI), Rheumatologist, Combined Rheumatology Practice; J. de Jager, MBBS, FRACP, Professor of Medicine, Gold Coast Rheumatology; H. Griffiths, MBBS, FRACP, Rheumatologist, Barwon Rheumatology Service; D. Nicholls, BHB, MBChB, FRACP, Rheumatologist, Coast Joint Care; J. Young, PhD, Medical Manager, Roche Products Propriety Limited; J. Zochling, MBBS, FRACP, MMed (ClinEpi), PhD, Rheumatologist, Menzies Research Institute Tasmania; K.E. Tymms, MBBS, FRACP, Associate Professor of Medicine, Canberra Rheumatology.
出版信息
J Rheumatol. 2015 Sep;42(9):1603-9. doi: 10.3899/jrheum.141575. Epub 2015 Jul 1.
OBJECTIVE
To evaluate disease activity trends in a large cohort of Australian patients with rheumatoid arthritis (RA) from 2009 to 2014.
METHODS
This is a multicenter, cross-sectional, noninterventional study of patients with RA treated in Australia. Patients with RA treated at participating OPAL (Optimising Patient outcome in Australian RheumatoLogy) clinics were included in the study. Data, deidentified by patient, clinic, and clinician, were identified using a purpose-written electronic medical record. Patient demographics, disease onset, medications, and disease measures were analyzed. The Disease Activity Score at 28 joints (DAS28) was used to classify patients into the disease activity states of remission: low disease activity, moderate disease activity (MDA), and high disease activity. Choice of therapy was at the discretion of the treating clinician.
RESULTS
At the time of analysis, the database contained 15,679 patients with RA, 8998 of whom fulfilled the inclusion criteria. Mean age was 63.2 years, mean disease duration was 13.8 years, and the majority were women (72.4%). A total of 37,274 individual DAS28-erythrocyte sedimentation rate scores were recorded for the 8998 patients. The frequency of remission increased significantly from 36.7% in 2009 to 53.5% in 2014 (p < 0.001), and that of MDA decreased from 33% (2009) to 22.2% (2014). The use of biologic disease-modifying antirheumatic drugs for the patients in remission increased from 17% in 2009 to 36.9% in 2014.
CONCLUSION
Contemporary management of RA in Australia shows improvements in disease activity toward the target of remission over a 5-year period.
目的
评估2009年至2014年澳大利亚一大群类风湿关节炎（RA）患者的疾病活动趋势。
方法
这是一项对在澳大利亚接受治疗的RA患者进行的多中心、横断面、非干预性研究。参与OPAL（澳大利亚风湿病优化患者结局）诊所治疗的RA患者被纳入研究。通过专门编写的电子病历识别经患者、诊所和临床医生去识别化的数据。分析患者人口统计学、疾病发病情况、药物治疗和疾病指标。采用28个关节疾病活动评分（DAS28）将患者分为缓解、低疾病活动、中度疾病活动（MDA）和高疾病活动状态。治疗方案由主治临床医生决定。
结果
在分析时，数据库包含15679例RA患者，其中8998例符合纳入标准。平均年龄为63.2岁，平均病程为13.8年，大多数为女性（72.4%）。共为8998例患者记录了37274个DAS28-红细胞沉降率单项评分。缓解率从2009年的36.7%显著增加到2014年的53.5%（p<0.001），MDA率从2009年的33%降至2014年的22.2%。缓解期患者使用生物改善病情抗风湿药的比例从2009年的17%增加到2014年的36.9%。
结论
澳大利亚对RA的当代管理显示，在5年期间疾病活动朝着缓解目标有所改善。
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