银屑病关节炎结局指标的变化对SF-36身体和心理成分得分的影响不同：一项观察性队列研究。
Change in psoriatic arthritis outcome measures impacts SF-36 physical and mental component scores differently: an observational cohort study.
作者信息
Skougaard Marie, Jørgensen Tanja S, Jensen Mia J, Ballegaard Christine, Guldberg-Møller Jørgen, Egeberg Alexander, Christensen Robin, Benzin Peter, Stisen Zara R, Merola Joseph F, Coates Laura C, Strand Vibeke, Mease Phillip, Kristensen Lars Erik
机构信息
The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.
Department of Dermatology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.
出版信息
Rheumatol Adv Pract. 2021 Nov 2;5(3):rkab076. doi: 10.1093/rap/rkab076. eCollection 2021.
OBJECTIVE
The objective was to investigate interplay and physical and mental component scores between change (Δ) in health-related quality of life (HRQoL) quantified by the physical component score (PCS) and mental component score (MCS) retrieved from short-form health survey (SF-36), change in disease activity (ΔDAS28CRP) and manifestations of PsA.
METHODS
PsA patients initiating new medical therapy were enrolled. Independent disease measures evaluating disease activity, enthesitis, psoriasis, pain and fatigue were collected at treatment initiation and after 4 months. Interplay between independent disease measures and dependent outcome measures, ΔPCS and ΔMCS, was described with univariate regression analyses. Multivariate regression analyses were applied to assess the impact of independent variables, such as individual disease outcome measures ΔDAS28CRP on ΔPCS and ΔMCS.
RESULTS
One hundred and eight PsA patients were included. In the univariate regression analyses, improvement in fatigue, pain and disability were associated with improvement in ΔPCS (β; -2.08, -0.18 and -13.00, respectively; all < 0.001) and ΔMCS (β; -1.59, -0.12 and -6.07, respectively; < 0.001, < 0.001 and = 0.003, respectively). When patient-reported outcomes were included in the final multivariate models, improvements in ΔPCS and ΔMCS were associated with improvements in pain, fatigue and disability ( < 0.001). Improvement in enthesitis impacted ΔPCS positively (β -0.31, < 0.001). No association was found between change in skin psoriasis, ΔPCS and ΔMCS (β 0.15, = 0.056 and β 0.05, = 0.561, respectively).
CONCLUSION
In this PsA patient cohort, diminishing pain, disability and fatigue improved PCS and MCS significantly. Changes in enthesitis and psoriasis did not grossly impact HRQoL compared with DAS28CRP. Individual PsA manifestations influence HRQoL differently, which is important clinically when targeting treatment.
TRIAL REGISTRATION
ClinicalTrials.gov, http://clinicaltrials.gov, NCT02572700.
目的
旨在研究通过简短健康调查问卷（SF - 36）得出的身体成分得分（PCS）和心理成分得分（MCS）所量化的健康相关生活质量（HRQoL）变化（Δ）、疾病活动度变化（ΔDAS28CRP）与银屑病关节炎（PsA）表现之间的相互作用以及身体和心理成分得分情况。
方法
纳入开始新药物治疗的PsA患者。在治疗开始时及4个月后收集评估疾病活动度、附着点炎、银屑病、疼痛和疲劳的独立疾病指标。通过单变量回归分析描述独立疾病指标与相关结局指标ΔPCS和ΔMCS之间的相互作用。应用多变量回归分析评估诸如个体疾病结局指标ΔDAS28CRP等自变量对ΔPCS和ΔMCS的影响。
结果
共纳入108例PsA患者。在单变量回归分析中，疲劳、疼痛和残疾的改善与ΔPCS的改善相关（β分别为 - 2.08、 - 0.18和 - 13.00；均<0.001）以及与ΔMCS的改善相关（β分别为 - 1.59、 - 0.12和 - 6.07；分别为<0.001、<0.001和 = 0.003）。当患者报告的结局纳入最终多变量模型时，ΔPCS和ΔMCS的改善与疼痛、疲劳和残疾的改善相关（<0.001）。附着点炎的改善对ΔPCS有正向影响（β - 0.31，<0.001）。未发现皮肤银屑病变化、ΔPCS和ΔMCS之间存在关联（β分别为0.15， = 0.056和β为0.05， = 0.并561）。
结论
在该PsA患者队列中，疼痛、残疾和疲劳的减轻显著改善了PCS和MCS。与DAS28CRP相比，附着点炎和银屑病的变化对HRQoL的影响不明显。PsA的个体表现对HRQoL的影响各不相同，这在临床治疗靶向时具有重要意义。
试验注册
ClinicalTrials.gov，http://clinicaltrials.gov，NCT02572700
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