Miwa Yusuke, Ikari Yuzo, Hosonuma Masahiro, Hatano Mika, Hayashi Tomoki, Kasama Tsuyoshi, Sanada Kenji
Department of Rheumatology, Showa University School of Medicine, Tokyo, Japan.
Department of Psychiatry, Showa University School of Medicine, Tokyo, Japan.
Eur J Rheumatol. 2018 Jul;5(2):111-114. doi: 10.5152/eurjrheum.2018.17147. Epub 2018 Jan 22.
To investigate the relationship between baseline factors and depression remission after a 6-month biological disease-modifying antirheumatic drugs (bDMARDs) treatment in rheumatoid arthritis (RA) patients.
The study was conducted in 152 RA patients treated with bDMARDs. The following patient's characteristics were studied: gender, age, disease duration, baseline prednisolone dosage, and serum matrix metalloproteinase3 (MMP3) levels. For assessment, we used the simple disease activity index (SDAI) for RA disease activity, Health Assessment Questionnaire Disability Index (HAQ-DI) for activities of daily living (ADL), Short Form-36 for nonspecific health-related quality of life (QOL), and Hamilton Depression Rating Scale (HAM-D) scores for the depression status. Depressed remission was clarified using HAM-D ≤7 after 6 months of treatment. The patients were divided into two groups according to the presence or absence of depression, and a retrospective study was conducted.
Based on binominal logistic analyses, RA patients' with depression remission (n=124) compared to those without depression remission (n=28) had a younger age (p=0.0045, odd ratio: 0.94, 95% confidence interval [CI]:0.8-0.98), female sex (p=0.021, odd ratio:0.21, 95% CI:0.054-0.79), and lower HAM-D scores (p=0.0073, odd ratio:0.85, 95% CI:0.76-0.96) CONCLUSION: It was proposed that RA patients who are females, younger in age, and have lower depressed scores at baseline can achieve a depression remission status with the bDMARDs treatment.
探讨类风湿关节炎（RA）患者在接受6个月生物改善病情抗风湿药物（bDMARDs）治疗后，基线因素与抑郁缓解之间的关系。
对152例接受bDMARDs治疗的RA患者进行研究。研究了以下患者特征：性别、年龄、病程、基线泼尼松龙剂量和血清基质金属蛋白酶3（MMP3）水平。评估时，我们使用类风湿关节炎疾病活动度的简易疾病活动指数（SDAI）、日常生活活动能力（ADL）的健康评估问卷残疾指数（HAQ-DI）、非特异性健康相关生活质量（QOL）的简短形式-36以及抑郁状态的汉密尔顿抑郁量表（HAM-D）评分。治疗6个月后，使用HAM-D≤7来明确抑郁缓解情况。根据是否存在抑郁将患者分为两组，并进行回顾性研究。
基于二项逻辑分析，与未缓解抑郁的患者（n = 28）相比，缓解抑郁的RA患者（n = 124）年龄更小（p = 0.0045，比值比：0.94，95%置信区间[CI]：0.8 - 0.98）、女性（p = 0.021，比值比：0.21，95% CI：0.054 - 0.79）且HAM-D评分更低（p = 0.0073，比值比：0.85，95% CI：0.76 - 0.96）。结论：提出女性、年龄较小且基线抑郁评分较低的RA患者通过bDMARDs治疗可实现抑郁缓解状态。
