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在接受常规临床治疗的类风湿关节炎患者中，基于患者报告结局指数和医师主导的疾病活动指数的缓解情况进行常规评估的一年维持治疗可能会抑制放射学进展：基于患者报告结局指数和医师主导的疾病活动指数的缓解情况进行维持治疗的放射学结局及其预后因素的回顾性比较。

One-year maintenance with routine assessment of patient index data 3-based remission may inhibit radiographic progression in patients with rheumatoid arthritis treated with routine clinical therapy: A retrospective comparison of radiographic outcome and its prognostic factors between maintained remissions with patient-reported outcome index and physician-oriented disease activity indices.

机构信息

a Katayama Orthopedic Rheumatology Clinic , Hokkaido , Japan.

b Seien Pharmacy , Hokkaido , Japan.

出版信息

Mod Rheumatol. 2016 Nov;26(6):817-827. doi: 10.3109/14397595.2016.1158766. Epub 2016 Mar 22.

DOI:10.3109/14397595.2016.1158766

PMID:26915909

Abstract

OBJECTIVES

We investigated whether the maintenance of routine assessment of patient index data 3 (RAPID3) remission for one year (RAPID3-MR) may predict good radiographic outcomes. We also compared radiographic progression to prognostic factors among patients with RAPID3-MR, with the maintenance of clinical disease activity index remission for one year (CDAI-MR) or with the maintenance of 28 joint count disease activity score remission for one year (DAS28-MR).

METHODS

Of 1220 patients with available clinical data, 92 with RAPID3-MR, 80 with RAPID3-NMR (not satisfying RAPID3-MR), 45 with CDAI-MR, and 75 with DAS28-MR were retrospectively investigated. CDAI and DAS28 for clinical outcomes and the modified total Sharp score (mTSS) for radiographic joint damage were investigated for at least one year.

RESULTS

RAPID3, CDAI, DAS28, and their categories remained unchanged or significantly improved in RAPID3-MR patients but significantly deteriorated in RAPID3-NMR patients. The mean annual ΔmTSS was significantly lower in RAPID3-MR patients (0.12 ± 0.55) than in RAPID3-NMR patients (0.54 ± 1.27) (p = 0.025). There was no significant difference among RAPID3-MR patients, CDAI-MR patients (0.06 ± 0.85), and DAS28-MR patients (0.11 ± 0.89). The baseline mTSS (p = 0.038) and monotherapy with nonbiological disease-modifying antirheumatic drugs (p = 0.033) were good prognostic factors in RAPID3-MR patients.

CONCLUSIONS

One-year RAPID3 remission maintenance may predict good radiographic outcomes.

摘要

目的

我们研究了维持患者指数数据 3（RAPID3）缓解一年（RAPID3-MR）是否可以预测良好的放射学结果。我们还比较了 RAPID3-MR 患者与维持临床疾病活动指数缓解一年（CDAI-MR）或维持 28 关节计数疾病活动评分缓解一年（DAS28-MR）患者之间的放射学进展与预后因素。

方法

在 1220 名具有可用临床数据的患者中，回顾性研究了 92 名 RAPID3-MR 患者、80 名 RAPID3-NMR（不符合 RAPID3-MR）患者、45 名 CDAI-MR 患者和 75 名 DAS28-MR 患者。至少对临床结局的 CDAI 和 DAS28 以及放射学关节损伤的改良总 Sharp 评分（mTSS）进行了一年以上的研究。

结果

RAPID3、CDAI、DAS28 及其类别在 RAPID3-MR 患者中保持不变或显著改善，但在 RAPID3-NMR 患者中显著恶化。RAPID3-MR 患者的平均年 ΔmTSS（0.12±0.55）显著低于 RAPID3-NMR 患者（0.54±1.27）（p=0.025）。RAPID3-MR 患者与 CDAI-MR 患者（0.06±0.85）和 DAS28-MR 患者（0.11±0.89）之间无显著差异。基线 mTSS（p=0.038）和非生物性疾病修饰抗风湿药物的单一疗法（p=0.033）是 RAPID3-MR 患者的良好预后因素。