(Dis)agreement of polymyalgia rheumatica relapse criteria, and prediction of relapse in a retrospective cohort.
(Dis)agreement of polymyalgia rheumatica relapse criteria, and prediction of relapse in a retrospective cohort.
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风湿性多肌痛复发标准的一致性，以及回顾性队列中复发的预测。
DOI：
10.1186/s41927-022-00274-y
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发表时间：
2022-08-02
期刊：
影响因子：
2.2
通讯作者：
van der Maas, Aatke
中科院分区：
文献类型：
--
作者：
Bolhuis, Thomas E.;Marsman, Diane;van den Hoogen, Frank H. J.;den Broeder, Alfons A.;den Broeder, Nathan;van der Maas, Aatke
开发和评估糖皮质激素（GC）治疗第一年内风湿性多肌痛（PMR）复发的预测模型。使用来自风湿病科的回顾性PMR队列（临床诊断）。开始GC治疗后> 30天且口服泼尼松龙> 2.5 mg/天的所有访视均用作潜在复发访视。评估了该队列中常用的复发标准（1）风湿病学家判断，（2）基于治疗强化的复发）的一致性。分别使用logistic和Poisson回归，使用治疗1年和2年内基于治疗的复发患者比例和复发发生率评估与候选预测因子的未校正相关性。在使用多重插补方法后，开发并评估了多变量模型，以预测治疗第一年内复发的发生率（是/否）。使用了417例患者的数据。根据风湿病学家判断和基于治疗的标准，分别在399次和321次（共2422次）访视时发生复发，两者之间的一致性为低至中度（87%（95% CI 0.86-0.88），κ = 0.49（95% CI 0.44-0.54））。前2年内的治疗复发与CRP、ESR和治疗前症状持续时间显著相关，仅与CRP和ESR相关的发生率显著相关。使用性别、心血管疾病和恶性肿瘤病史、治疗前症状持续时间、ESR和Hb开发了一个预测治疗第一年内治疗强化的模型，AUC为0.60-0.65。PMR复发频繁发生，尽管常用标准仅显示中度一致性，但强调了PMR特异性复发的统一定义和标准的重要性。使用实用预测因子开发了一个预测治疗强化的模型，尽管其性能不高。在线版本包含补充材料，可通过10.1186/s41927-022-00274-y获得。
To develop and assess a prediction model for polymyalgia rheumatica (PMR) relapse within the first year of glucocorticoid (GC) treatment. A retrospective PMR cohort (clinical diagnosis) from a rheumatology department was used. All visits > 30 days after starting GC treatment and with > 2.5 mg/day oral prednisolone were used as potential relapse visits. Often used relapse criteria (1) rheumatologist judgement, (2) treatment intensification-based relapse) were assessed for agreement in this cohort. The proportion of patients with treatment-based relapse within 1 and 2 years of treatment and the relapse incidence rate were used to assess unadjusted associations with candidate predictors using logistic and Poisson regression respectively. After using a multiple imputation method, a multivariable model was developed and assessed to predict the occurrence (yes/no) of relapse within the first year of treatment. Data from 417 patients was used. Relapse occurred at 399 and 321 (of 2422) visits based on the rheumatologist judgement- and treatment-based criteria respectively, with low to moderate agreement between the two (87% (95% CI 0.86–0.88), with κ = 0.49 (95% CI 0.44–0.54)). Treatment-based relapse within the first two years was significantly associated with CRP, ESR, and pre-treatment symptom duration, and incidence rate with only CRP and ESR. A model to predict treatment intensification within the first year of treatment was developed using sex, medical history of cardiovascular disease and malignancies, pre-treatment symptom duration, ESR, and Hb, with an AUC of 0.60–0.65. PMR relapse occurs frequently, although commonly used criteria only show moderate agreement, underlining the importance of a uniform definition and criteria of a PMR specific relapse. A model to predict treatment intensification was developed using practical predictors, although its performance was modest. The online version contains supplementary material available at 10.1186/s41927-022-00274-y.
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影响因子：
39.2
作者：
Collins, Gary S.;Reitsma, Johannes B.;Moons, Karel G. M.
通讯作者：
Moons, Karel G. M.
影响因子：
27.4
作者：
Salvarani, C;Boiardi, L;Macchioni, P
通讯作者：
Macchioni, P
DOI：
10.1002/art.22630
发表时间：
2007-04-15
期刊：
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH
影响因子：
--
作者：
Binard, Aymeric;De Bandt, Michel;Saraux, Alain
通讯作者：
Saraux, Alain
影响因子：
4
作者：
Lee, Jung Hwa;Choi, Sang Tae;Kim, Hae-Rim
通讯作者：
Kim, Hae-Rim
DOI：
10.1002/art.20901
发表时间：
2005-02-15
期刊：
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH
影响因子：
--
作者：
Salvarani, C;Cantini, F;Boiardi, L
通讯作者：
Boiardi, L