Multibiomarker disease activity score and C-reactive protein in a cross-sectional observational study of patients with rheumatoid arthritis with and without concomitant fibromyalgia.
Multibiomarker disease activity score and C-reactive protein in a cross-sectional observational study of patients with rheumatoid arthritis with and without concomitant fibromyalgia.
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DOI：
10.1093/rheumatology/kev388
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发表时间：
2016-04
期刊：
影响因子：
--
通讯作者：
Sasso EH
中科院分区：
文献类型：
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作者：
Lee YC;Hackett J;Frits M;Iannaccone CK;Shadick NA;Weinblatt ME;Segurado OG;Sasso EH
目标。旨在检查伴有或不伴有 FM 的 RA 患者的多生物标志物疾病活动 (MBDA) 评分、CRP 和临床疾病活动测量之间的关联。方法。在确诊 RA 患者的观察队列中，我们通过等级相关和交叉分类对 MBDA 评分与 CRP 进行了横断面分析。通过单变量和多变量分析，比较仅患有 RA 的患者和伴有 FM 的 RA 患者（RA 和 FM）之间的 MBDA 评分、CRP 和疾病活动的临床测量。结果。 198 名患者中有 184 名 (93%) 的 CRP ≤ 1.0 mg/dl。 MBDA 评分与 CRP 相关（r = 0.755，P < 0.001），但常常不一致，CRP ≤ 0.1、0.1 至 ≤ 0.3 或 0.3 至 ≤ 1.0 mg/dl 的患者分别有 19%、55% 和 87% 的患者为中等或高。在 CRP ≤ 1.0 mg/dl 的患者中，肿胀关节计数 (SJC) 在 MBDA 评分水平上呈线性增加，无论是否对 CRP 进行调整（P = 0.021）和不调整（P = 0.004），而 CRP 与 SJC 无关。 RA 和 FM 患者 (n = 25) 的 28 关节 DAS-CRP、其他综合测量值及其非关节计数成分测量值显着高于单独 RA (n = 173) 的患者（所有 P ≤ 0.005）。组间 MBDA 评分和 CRP 相似。结论。 MBDA 评分经常表明 RA 疾病活动，而 CRP 则不然。与单纯 RA 患者相比，患有 RA 和 FM 的患者两者均没有显着增加。因此，MBDA 评分可能是一种有用的客观测量方法，用于识别 CRP 较低（⩽1.0 mg/dl）时患有活动性炎症的 RA 患者，包括伴有 FM 的 RA 患者。
Objectives. To examine the association between a multibiomarker disease activity (MBDA) score, CRP and clinical disease activity measures among RA patients with and without concomitant FM. Methods. In an observational cohort of patients with established RA, we performed a cross-sectional analysis comparing MBDA scores with CRP by rank correlation and cross-classification. MBDA scores, CRP and clinical measures of disease activity were compared between patients with RA alone and RA with concomitant FM (RA and FM) by univariate and multivariate analyses. Results. CRP was ⩽1.0 mg/dl for 184 of 198 patients (93%). MBDA scores correlated with CRP (r = 0.755, P < 0.001), but were often discordant, being moderate or high for 19%, 55% and 87% of patients with CRP ⩽0.1, 0.1 to ⩽0.3, or 0.3 to ⩽1.0 mg/dl, respectively. Among patients with CRP ⩽1.0 mg/dl, swollen joint count (SJC) increased linearly across levels of MBDA score, both with (P = 0.021) and without (P = 0.004) adjustment for CRP, whereas CRP was not associated with SJC. The 28-joint-DAS-CRP, other composite measures, and their non-joint-count component measures were significantly greater for patients with RA and FM (n = 25) versus RA alone (n = 173) (all P ⩽ 0.005). MBDA scores and CRP were similar between groups. Conclusion. MBDA scores frequently indicated RA disease activity when CRP did not. Neither one was significantly greater among patients with RA and FM versus RA alone. Thus, MBDA score may be a useful objective measure for identifying RA patients with active inflammation when CRP is low (⩽1.0 mg/dl), including RA patients with concomitant FM.