Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Immunology/Rheumatology, Stanford University, Stanford, California, USA.
RMD Open. 2019 Sep 6;5(2):e001002. doi: 10.1136/rmdopen-2019-001002. eCollection 2019.
To comprehensively assess evidence on the measurement properties of the minimal disease activity (MDA) criteria, a composite measure of the state of disease activity in psoriatic arthritis (PsA).
A targeted literature review was conducted to identify studies that informed the validity and/or ability of the MDA to detect change among patients known to have experienced a change in clinical status. The search was conducted using MEDLINE and Embase databases (published as of October 2017). Pertinent articles provided by investigators and identified from select conference proceedings were also evaluated.
A total of 20 publications met the inclusion criteria. The MDA criteria were consistently associated with other indicators of disease activity/severity. The ability of the MDA criteria to detect change was supported in randomised controlled trials (n=10), with a greater percentage of patients randomised to active treatments achieving MDA relative to patients in comparator arms. Long-term observational studies (n=2) provided additional support for the ability of the MDA to detect within-subject change in the real-world settings.
Evidence supports the MDA as a valid measure of disease activity in PsA that can detect between-group and within-subject change. The MDA is a comprehensive measure and clinically meaningful endpoint to assess the impact of interventions on PsA disease activity.
全面评估最小疾病活动(MDA)标准的测量特性,这是一种评估银屑病关节炎(PsA)疾病活动状态的综合指标。
进行了一项有针对性的文献回顾,以确定那些能为 MDA 的有效性和/或检测已知临床状态发生变化的患者变化的能力提供信息的研究。检索使用了 MEDLINE 和 Embase 数据库(截至 2017 年 10 月出版)。还评估了研究人员提供的相关文章和从精选会议论文集中确定的文章。
共有 20 篇出版物符合纳入标准。MDA 标准与其他疾病活动/严重程度的指标始终相关。MDA 标准检测变化的能力在随机对照试验(n=10)中得到支持,与比较组的患者相比,更多随机分配到积极治疗的患者达到 MDA。两项长期观察性研究(n=2)为 MDA 在真实环境中检测个体内变化的能力提供了额外的支持。
证据支持 MDA 作为评估 PsA 疾病活动的有效指标,能够检测组间和个体内的变化。MDA 是一种全面的衡量标准和有临床意义的终点,可用于评估干预措施对 PsA 疾病活动的影响。