Catan Liliana, Boariu Marius, Amaricai Elena, Popa Daniel, Puenea George, Drăgoi Mihai, Stratul Ștefan, Drăgoi Răzvan Gabriel
Department of Balneology, Medical Rehabilitation and Rheumatology, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Department of Endodontics, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Exp Ther Med. 2021 Jan;21(1):89. doi: 10.3892/etm.2020.9521. Epub 2020 Nov 26.
This prospective study explored the link between values of C-reactive protein (CRP) in patients with SpA (ankylosing spondylitis, psoriatic arthritis, reactive arthritis, or arthritis-related inflammatory bowel disease) and functional disability in order to derive an algorithm that may predict functional disability based on disease activity. Patients diagnosed with Spa were classified into five groups based on the type of therapy and they were followed up for 3 years. Group 1: Symptomatic medication alone; Group 2: Disease-modifying antirheumatic drugs (DMARDs); Group 3: DMARDs and 30 rehabilitation sessions twice a year; Group 4: Group 3 therapy and biologic anti-tumor necrosis factor-alpha (anti-TNF-α) drugs; and Group 5: Group 4 therapy and, in addition, a daily home-adapted kinesiotherapy program. CRP, modified Health Assessment Questionnaire (mHAQ-S), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and T-score of the patients were recorded. Correlation and multivariate regression analyses were conducted using demographic data, CRP, and mHAQ-S scores to derive the CRP-mHAQ-S correlation algorithm. Statistical analysis included the chi-square, Mann-Whitney, and multiple regression tests and repeated measures analysis of variance. A total of 144 patients were enrolled, all of whom completed the study. The best predictive model (P<0.001) provided the algorithm mHAQ-S=17.14+0.12xCRP-0.24xCRP-0.15xCRP (CRP, CRP, and CRP correspond to CRP levels at baseline, 12, and 36 months, respectively, and mHAQ-S to mHAQ-S score at 36 months). This derived algorithm based on objective CRP assessment may have implications in the prediction of functional disability evolution in patients with SpA.
这项前瞻性研究探讨了脊柱关节炎（SpA，包括强直性脊柱炎、银屑病关节炎、反应性关节炎或与关节炎相关的炎症性肠病）患者的C反应蛋白（CRP）值与功能残疾之间的联系，以便得出一种可根据疾病活动预测功能残疾的算法。被诊断为SpA的患者根据治疗类型分为五组，并随访3年。第1组：仅使用对症药物；第2组：改善病情抗风湿药（DMARDs）；第3组：DMARDs且每年进行30次康复治疗；第4组：第3组治疗加生物抗肿瘤坏死因子-α（抗TNF-α）药物；第5组：第4组治疗，此外还有每日家庭适应性运动疗法计划。记录患者的CRP、改良健康评估问卷（mHAQ-S）、巴斯强直性脊柱炎疾病活动指数（BASDAI）和T评分。使用人口统计学数据、CRP和mHAQ-S评分进行相关性和多变量回归分析，以得出CRP-mHAQ-S相关算法。统计分析包括卡方检验、曼-惠特尼检验、多元回归检验和重复测量方差分析。共纳入144例患者，所有患者均完成研究。最佳预测模型（P<0.001）得出算法mHAQ-S=17.14+0.12xCRP-0.24xCRP-0.15xCRP（CRP、CRP和CRP分别对应基线、12个月和36个月时的CRP水平，mHAQ-S对应36个月时的mHAQ-S评分）。这种基于客观CRP评估得出的算法可能对预测SpA患者功能残疾的演变具有重要意义。
