Ishiguro Naoki, Dougados Maxime, Cai Zhihong, Zhu Baojin, Ishida Masato, Sato Masayo, Gaich Carol, Quebe Amanda, Stoykov Ivaylo, Tanaka Yoshiya
a Department of Orthopedic Surgery , Nagoya University Graduate School and School of Medicine , Nagoya , Japan.
b Hôpital Cochin , Paris , France.
Mod Rheumatol. 2018 Nov;28(6):950-959. doi: 10.1080/14397595.2017.1422232. Epub 2018 Feb 2.
To examine patient-reported outcomes (PROs) in patients with different rheumatoid arthritis (RA) disease activity levels and identify residual symptoms.
Post hoc analyses of overall and Japanese data from two randomized controlled trials including RA patients with previous inadequate responses to methotrexate (NCT01710358) or no/minimal previous disease-modifying antirheumatic drug treatment (NCT01711359) (sponsor: Eli Lilly and Company). Week 24 assessments were disease activity (Simplified Disease Activity Index, Disease Activity Score/Disease Activity Score 28 joints-erythrocyte sedimentation rate) and PROs (pain visual analog scale [VAS], morning joint stiffness [MJS], Health Assessment Questionnaire-Disability Index, Functional Assessment of Chronic Illness Therapy-Fatigue, and Medical Outcomes Study Short Form 36 Health Survey Physical and Mental Component Scores).
Patients achieving remission/low disease activity (LDA) at Week 24 had larger/significant improvements from baseline in pain, MJS, disability, fatigue, and physical and emotional quality of life versus patients with high/moderate disease activity. Some patients achieving remission and LDA, reported residual pain (pain VAS >10 mm): 20.8-39.3% and 48.7-70.0% (overall study populations), 16.0-34.5% and 47.1-62.0% (Japanese patients). Residual MJS and fatigue were also reported.
Remission/LDA were associated with improvements in PROs in overall and Japanese patient populations; however, some patients achieving remission had residual symptoms, including pain.
研究不同类风湿关节炎(RA)疾病活动水平患者的患者报告结局(PROs),并识别残留症状。
对两项随机对照试验的总体数据和日本数据进行事后分析,这两项试验的受试者包括先前对甲氨蝶呤反应不足的RA患者(NCT01710358)或先前未接受/仅接受极少改善病情抗风湿药物治疗的患者(NCT01711359)(主办方:礼来公司)。第24周的评估指标包括疾病活动度(简化疾病活动指数、疾病活动评分/28个关节疾病活动评分-红细胞沉降率)和PROs(疼痛视觉模拟量表[VAS]、晨僵[MJS]、健康评估问卷-残疾指数、慢性病治疗功能评估-疲劳,以及医学结局研究简明健康调查身体和精神成分评分)。
与疾病活动度高/中度的患者相比,在第24周达到缓解/低疾病活动度(LDA)的患者在疼痛、MJS、残疾、疲劳以及身体和情绪生活质量方面较基线有更大/显著改善。一些达到缓解和LDA的患者报告有残留疼痛(疼痛VAS>10 mm):20.8%-39.3%和48.7%-70.0%(总体研究人群),16.0%-34.5%和47.1%-62.0%(日本患者)。还报告了残留的MJS和疲劳。
缓解/LDA与总体和日本患者人群的PROs改善相关;然而,一些达到缓解的患者有残留症状,包括疼痛。