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在日常临床实践中,类风湿关节炎患者接受托法替布治疗的依从性。

Adherence to treatment with tofacitinib in patients with rheumatoid arthritis in daily clinical practice.

机构信息

Instituto de Rehabilitación Psicofísica (IREP), Ciudad de Buenos Aires, Argentina.

Instituto de Rehabilitación Psicofísica (IREP), Ciudad de Buenos Aires, Argentina.

出版信息

Reumatol Clin (Engl Ed). 2022 Mar;18(3):164-168. doi: 10.1016/j.reumae.2020.11.003. Epub 2021 Jul 21.

Abstract

OBJECTIVES

To evaluate the adherence to treatment with Tofacitinib in patients with Rheumatoid Arthritis (RA) using two versions of the self-questionnaire Compliance Questionnaire Rheumatology, CQR19 and CQR5, to determine the variables associated with adherence to Tofacitinib and to compare the performance of both questionnaires.

MATERIAL AND METHODS

A cross-sectional study was carried out. We included patients ≥18 years old, with RA (ACR/EULAR criteria 2010) under treatment with Tofacitinib. Sociodemographic data, clinical characteristics, treatment and data on patient evaluation. All the patients completed self-questionnaires CQR19 and CQR5.

STATISTICAL ANALYSIS

Descriptive statistics. t-Test or Mann Whitney to compare the continuous variables, Chi test or Fisher's exact test for the categorical ones. Kappa concordance index. Multiple logistic regression.

RESULTS

We included 52 patients, 82.7% women, with a median (m) age of 57.7 years, disease duration m 16 years, 63.5% had comorbidities. Of the patients, 86.5% were treated with Tofacitinib (5 mg BID) and 48% received Tofacitinib as monotherapy. The median time of Tofacitinib treatment was 13 months, 42.3% suspended treatment, and only one patient permanently stopped treatment due to lack of provision. Median CQR19 was 89.5% and 84.6% had an adherence ≥ 80%. The variables significantly associated with adherence ≥ 80% were the presence of comorbidities (p = .014) and older age (p = .033). Considering the CQR5, a similar percentage of patients (82.7%) were adherents to treatment, however, the concordance with CQR19 was low. In the multivariate analysis, older age was the only variable independently associated with good adherence to treatment.

CONCLUSIONS

Treatment adherence to Tofacitinib was very good for both presentations. Older age was associated with higher adherence. The agreement between the questionnaires CQR19 and CQR5 was low.

摘要

目的

使用两种自我问卷 Compliance Questionnaire Rheumatology(CQR19 和 CQR5)评估类风湿关节炎(RA)患者接受托法替布治疗的依从性,确定与托法替布依从性相关的变量,并比较两种问卷的性能。

材料和方法

进行了一项横断面研究。我们纳入了年龄≥18 岁、正在接受托法替布治疗的 RA(ACR/EULAR 2010 标准)患者。收集患者的社会人口统计学数据、临床特征、治疗情况和患者评估数据。所有患者均完成了自我问卷 CQR19 和 CQR5。

统计分析

描述性统计。t 检验或曼-惠特尼检验用于比较连续变量,卡方检验或 Fisher 确切概率法用于比较分类变量。kappa 一致性指数。多因素逻辑回归。

结果

共纳入 52 例患者,82.7%为女性,中位(m)年龄为 57.7 岁,疾病病程 m16 年,63.5%合并症。患者中 86.5%接受托法替布(5mg BID)治疗,48%接受托法替布单药治疗。托法替布治疗的中位时间为 13 个月,42.3%停药,仅 1 例患者因供应不足而永久停药。CQR19 中位数为 89.5%,84.6%的患者依从性≥80%。与依从性≥80%显著相关的变量是合并症的存在(p=0.014)和年龄较大(p=0.033)。考虑到 CQR5,有相似比例的患者(82.7%)对治疗具有依从性,但与 CQR19 的一致性较低。在多因素分析中,年龄较大是与良好治疗依从性相关的唯一独立变量。

结论

两种问卷评估托法替布治疗的依从性都非常好。年龄较大与较高的依从性相关。CQR19 和 CQR5 问卷之间的一致性较低。

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