在伴有轴性银屑病关节炎的患者中，缓解与疾病低影响之间存在良好的临床计量学一致性。

Good clinimetric alignment between remission and a low impact of disease in patients with axial psoriatic arthritis.

机构信息

Rheumatology Division, Hospital Universitario Central de Asturias, Oviedo, Spain.

Arthritis Unit, Rheumatology Division, Hospital Clinic, Barcelona, Spain.

出版信息

Clin Exp Rheumatol. 2020 Jan-Feb;38(1):136-139. Epub 2019 Jul 19.

PMID:31376259

Abstract

OBJECTIVES

The concept of axial disease in psoriatic arthritis (PsA) is not well established. It is also unclear how this disease domain should be evaluated. We aimed to test whether the remission is aligned with a low impact state of the disease in patients with axial PsA.

METHODS

Post hoc analysis of a multicentre study conducted in 223 patients with PsA under treatment with systemic biological and non-biological therapies. To define axial disease, ASAS criteria were used. Remission corresponded to a BASDAI less than or equal to 2. The impact of the disease was evaluated according to the PsAID. The Cohen's kappa agreement between remission and patient-acceptable symptoms state (PASS) was analysed.

RESULTS

Thirty-seven of the 223 patients (16.6%) met ASAS criteria for axial disease. Fifteen of the 122 (12.3%) patients in PASS situation had axial disease compared to 22 of 101 (21.8%) who did not reach this state, p<0.05. All items, as well as the total score of the BASDAI (4.48±2.03 vs. 1.14±1.02) were significantly higher in the patients who did not achieve a PASS, p<0.001. The kappa agreement between BASDAI remission and PASS was high [κ: 0.73 (95%CI: 0.64-0.83) p<0.0001].

CONCLUSIONS

BASDAI remission and a low impact of the disease show good clinimetric alignment. Both measures could be useful for a more comprehensive assessment of axial disease in PsA.

摘要

目的

银屑病关节炎（PsA）的轴性疾病概念尚未得到很好的确立。目前也不清楚应如何评估这一疾病领域。我们旨在检验在接受系统性生物和非生物治疗的轴性 PsA 患者中，缓解是否与疾病的低影响状态相一致。

方法

对接受系统性生物和非生物治疗的 223 例 PsA 患者进行的一项多中心研究的事后分析。为了定义轴性疾病，采用 ASAS 标准。缓解定义为 BASDAI 小于或等于 2。根据 PsAID 评估疾病的影响。分析缓解与患者可接受的症状状态（PASS）之间的 Cohen's kappa 一致性。

结果

223 例患者中有 37 例（16.6%）符合 ASAS 的轴性疾病标准。在 PASS 状态的 122 例患者中有 15 例（12.3%）存在轴性疾病，而未达到这一状态的 101 例患者中有 22 例（21.8%），p<0.05。在未达到 PASS 的患者中，所有项目以及 BASDAI 的总分（4.48±2.03 与 1.14±1.02）均显著更高，p<0.001。BASDAI 缓解与 PASS 之间的 kappa 一致性很高[κ：0.73（95%CI：0.64-0.83），p<0.0001]。