类风湿性关节炎患者病程越早治疗缓解机率越高:来自 CORRONA注册系统的结果

原文

译文

Arthritis Care Res (Hoboken). 2011 Feb 18. doi: 10.1002/acr.20452. [Epub ahead of print] Greater likelihood of remission in rheumatoid arthritis patients treated earlier in disease course: Results from the CORRONA registry. Furst DE, Pangan AL, Harrold LR, Chang H, Reed G, Kremer JM, Greenberg JD. Geffen School of Medicine at the University of California, Los Angeles, CA United States. Abstract OBJECTIVE.: To examine whether disease duration is an independent predictor of achieving remission in rheumatoid arthritis (RA) patients initiating therapy. METHODS.: RA patients in the CORRONA registry newly prescribed a nonbiologic disease modifying antirheumatic drug (nbDMARD) or anti-TNF with at least one follow-up visit were identified. Achievement of remission was defined using the Clinical Disease Activity Index (CDAI ≤ 2.8) and 28 joint Disease Activity Score (DAS28 < 2.6) at any follow-up visit within one year; sustained remission was defined as remission during any two successive visits. Likelihood of remission was examined through logistic regression based on 5 year increments of disease duration adjusting for baseline covariates. RESULTS.: Among the 1,646 nbDMARD initiators, CDAI remission occurred in 21.3% of those with ≤ 5 years disease duration, 19.6% with 6-10 years and 13.5% with ≥ 11 years (p<0.0001); sustained remission occurred in 10.2%, 8.8% and 2.5% respectively (p<0.001). Results were similar among the 3,179 anti-TNF initiators (CDAI remission in 22.3%, 17.7%, and 12.8% respectively [(p<0.001]; CDAI sustained remission in 9.7%, 9.5% and 4.2% respectively [p<.0.001]). DAS28 results were similar in both groups. In adjusted analyses, an increase of disease duration by 5 years was associated with a reduced likelihood of CDAI remission in nbDMARD (OR 0.91, 95% CI 0.83-0.99) and anti-TNF initiators (OR 0.88, 95% CI 0.83-0.94). A similar result was seen for sustained remission using CDAI (nbDMARD: OR 0.61, 95% CI 0.48-0.76; anti-TNF: OR 0.85, 95% CI 0.75 - 0.97). CONCLUSIONS.: Earlier treatment was associated with a greater likelihood of remission.

类风湿性关节炎患者病程越早治疗缓解机率越高:来自 CORRONA注册系统的结果 Furst DE, Pangan AL, et al,Arthritis Care Res (Hoboken). 2011 Feb 18. doi: 10.1002/acr.20452. 目的:检测病程长短是否是类风湿性关节炎(RA)患者初始治疗能否达到缓解的独立预测因素。方法:检索了CORRONA登记系统中新近应用非生物改变病情抗风湿药(nbDMARD)或抗-TNF治疗随访至少一次的患者。疾病缓解定义为一年内任何的一次随访时，临床疾病活动指数(CDAI)≤2.8和28个关节疾病活动积分（DAS28)< 2.6;持续缓解定义为任何两次连续随访都达到缓解。根据5年内病程增加对基线变量做出校正，回归分析检测了缓解的机率。结果: 1,646例 nbDMARD初始应用者中，病程≤5年的患者CDAI缓解率为21.3%,病程6- 10年的为19.6%，≥11年的为13.5%(p < 0.0001);持续缓解率在上述三组中分别为10.2%，8.8%和2.5%(p < 0.001)。3179例抗-TNF起始治疗的患者，结果也相似（CDAI缓解率分别为22.3%，17.7%和12.8%[p < 0.001]；CDAI持续缓解率分别为9.7%,9.5%和4.2%[p < .0.001])。DAS28结果在两组间相似。校正分析后，nbDMARD治疗的患者获得CDAI缓解机率随着5年中病程增加而下降(OR 0.91,95%CI 0.83-0.99)，抗-TNF治疗患者也一样(OR 0.88,95%CI 0.83-0.94)。CDAI持续缓解的结果与此类似 (nbDMARD:OR 0.61,95%CI 0.48-0.76;抗-TNF:OR 0.85,95%CI 0.75-0.97)。结论:越早治疗缓解机率越高。

转载于:https://www.cnblogs.com/T2T4RD/archive/2011/03/31/5464310.html