Radiographic assessment of disease progression in rheumatoid arthritis patients enrolled in the cooperative systematic studies of the rheumatic diseases program randomized clinical trial of methotrexate, auranofin, or a combination of the two.
Radiographic assessment of disease progression in rheumatoid arthritis patients enrolled in the cooperative systematic studies of the rheumatic diseases program randomized clinical trial of methotrexate, auranofin, or a combination of the two.
复制标题
对参加风湿性疾病计划随机临床试验（甲氨蝶呤、金诺芬或两者组合）的合作系统研究的类风湿性关节炎患者的疾病进展进行放射学评估。
DOI：
10.1002/art.1780361006
复制
发表时间：
1993
影响因子：
--
通讯作者：
Alarcón,GS
中科院分区：
文献类型：
--
作者：
López-Méndez,A;Daniel,WW;Reading,JC;Ward,JR;Alarcón,GS
目标。为了确定类风湿关节炎（RA）患者的影像学进展情况，研究了风湿病合作系统研究中auranofin （AUR）与甲氨蝶呤（MTX）的临床试验，以及两者的联合应用。方法：完成这项多中心试验的211例患者中，有200例（95%）完成了基线（第0周）和研究结束（第48周）的手/手腕x线片，由2名读者对侵蚀和关节间隙狭窄（JSN）的存在进行了盲目评分。侵蚀的观察者内信度和观察者间信度均为0.80 (P≤0.001)；JSN的观察者内信度和观察者间信度均为0.75 （P≤0.001）。所有3个治疗组的糜烂和JSN评分均出现恶化，但只有AUR组与基线有显著差异。结论：本试验中所有3个治疗组均有明显的临床改善记录。即使临床特征改善，RA的影像学恶化也会发生，但放射学上确定的疾病进展可能会因MTX治疗而减慢。
Objective.To determine the radiographic progression of disease in rheumatoid arthritis (RA) patients from the Cooperative Systematic Studies of the Rheumatic Diseases clinical trial of auranofin (AUR) versus methotrexate (MTX) versus a combination of the two.Methods.Baseline (week‐0) and study‐end (week‐48) hand/wrist radiographs in 200 of the 211 patients who completed this multicenter trial (95%) were scored blindly by 2 readers for the presence of erosions and joint space narrowing (JSN). Both intraobserver reliability and interobserver reliability were 0.80 for erosions (P≤ 0.001); intraobserver reliability and interobserver reliability were both 0.75 for JSN (P≤ 0.001).Results.Worsening erosion and JSN scores occurred in all 3 treatment groups, but the difference from baseline reached significance only in the AUR group.Conclusion.Clinical improvement has been clearly documented in all 3 treatment groups in this trial. Radiographic deterioration occurs in RA even when clinical features improve, but progression of disease as determined radiographically may be slowed by treatment with MTX.