Zhang Yuqi, Du Keqian, Feng Xiaoxue, Xu Jia, Xu Peijun, Huang Jianlin
Department of Rheumatology, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China.
Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
J Inflamm Res. 2024 Oct 11;17:7183-7193. doi: 10.2147/JIR.S472549. eCollection 2024.
This study aimed to compare the rates of disease remission evaluated using various remission criteria, including Boolean2.0, Boolean1.0, clinical disease activity index (CDAI), simplified disease activity index (SDAI), and disease activity score using 28 joints based on C-reactive protein (DAS28-CRP) in patients with rheumatoid arthritis (RA).
A cross-sectional observational analysis was performed using data from patients with RA enrolled in a smart system of disease management group (SSDM). The clinical remission rates of RA patients estimated using the DAS28-CRP, CDAI, SDAI, Boolean1.0 and Boolean2.0 criteria were investigated. Variables were compared using the -test, -test, or -squared test. The agreement between Boolean remission and the DAS28-CRP, CDAI, or SDAI definitions of remission was assessed using McNemar's test with k coefficient of agreement.
A total of 5619 patients were included in the analysis. The mean age of the patients was 56.33 (±13.01) years, with the majority being female (4491, 79.9%). The rates of remission, as assessed by Boolean2.0, Boolean1.0, DAS28-CRP, CDAI, and SDAI, were 16.6%, 9.7%, 35.2%, 9.1%, and 9.4%, respectively. Comparison with Boolean1.0 criteria revealed higher concordance between Boolean2.0 and DAS28-CRP remission and lower concordance with CDAI and SDAI, regardless of whether the analysis was conducted on the entire population or subgroups based on gender, age or disease duration. Additionally, the administration of different medications may have influenced the rate of Boolean2.0 remission.
This study demonstrated a higher concordance between Boolean2.0 criteria and DAS28-CRP remission and a lower concordance with CDAI and SDAI when compared with Boolean1.0 remission criteria.
本研究旨在比较类风湿关节炎（RA）患者中，使用多种缓解标准评估的疾病缓解率，这些标准包括布尔2.0、布尔1.0、临床疾病活动指数（CDAI）、简化疾病活动指数（SDAI）以及基于C反应蛋白的28关节疾病活动评分（DAS28-CRP）。
使用纳入疾病管理组智能系统（SSDM）的RA患者数据进行横断面观察分析。研究了使用DAS28-CRP、CDAI、SDAI、布尔1.0和布尔2.0标准估计的RA患者临床缓解率。使用t检验、u检验或卡方检验比较变量。使用带有一致性k系数的McNemar检验评估布尔缓解与DAS28-CRP、CDAI或SDAI缓解定义之间的一致性。
共有5619例患者纳入分析。患者的平均年龄为56.33（±13.01）岁，大多数为女性（4491例，79.9%）。通过布尔2.0、布尔1.0、DAS28-CRP、CDAI和SDAI评估的缓解率分别为16.6%、9.7%、35.2%、9.1%和9.4%。与布尔1.0标准相比，无论对总体人群还是基于性别、年龄或病程的亚组进行分析，布尔2.0与DAS28-CRP缓解之间的一致性更高，与CDAI和SDAI的一致性更低。此外，不同药物的使用可能影响了布尔2.0缓解率。
本研究表明，与布尔1.0缓解标准相比，布尔2.0标准与DAS28-CRP缓解之间的一致性更高，与CDAI和SDAI的一致性更低。
