Prediction of disease relapses by multibiomarker disease activity and autoantibody status in patients with rheumatoid arthritis on tapering DMARD treatment.
Prediction of disease relapses by multibiomarker disease activity and autoantibody status in patients with rheumatoid arthritis on tapering DMARD treatment.
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DOI：
10.1136/annrheumdis-2015-207900
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发表时间：
2016-09
影响因子：
27.4
通讯作者：
Schett G
中科院分区：
文献类型：
--
作者：
Rech J;Hueber AJ;Finzel S;Englbrecht M;Haschka J;Manger B;Kleyer A;Reiser M;Cobra JF;Figueiredo C;Tony HP;Kleinert S;Wendler J;Schuch F;Ronneberger M;Feuchtenberger M;Fleck M;Manger K;Ochs W;Schmitt-Haendle M;Lorenz HM;Nuesslein H;Alten R;Henes J;Krueger K;Schett G
在RETRO中，分析多生物标志物疾病活动性（MBDA）评分在预测持续缓解的类风湿关节炎（RA）患者疾病复发中的作用，这些患者逐渐减少了疾病修饰抗风湿药物（DMARD）治疗，这是一项前瞻性随机对照试验。基于来自RETRO研究的94名患者的基线血清样品中的12种炎症标志物来确定MBDA评分（量表1-100）。在逐渐减少DMARD时，比较复发或保持缓解的患者之间的MBDA评分。人口统计学和疾病特异性参数被纳入多变量logistic回归分析，以确定复发的预测因素。在33%的RA患者中发现了中度至高度MBDA评分。复发患者（58%）的中度/高度MBDA是保持缓解患者（21%）的两倍。复发RA患者的基线MBDA评分显著高于保持稳定缓解（N=94; p=0.0001）和逐渐减少/停止（N=59; p=0.0001）的患者。多变量回归分析确定MBDA评分是除抗瓜氨酸蛋白抗体（ACPA）状态外复发的独立预测因子。MBDA−/ACPA−患者的复发率较低（13%），MBDA+/ACPA−（33.3%）和MBDA−ACPA+（31.8%）患者的复发率中等，MBDA+/ACPA+（76.4%）患者的复发率较高。MBDA改善了接受DMARD减量的稳定缓解RA患者复发的预测。如果与ACPA测试相结合，MBDA可以预测超过80%的患者复发。EudraCT 2009-015740-42。
To analyse the role of multibiomarker disease activity (MBDA) score in predicting disease relapses in patients with rheumatoid arthritis (RA) in sustained remission who tapered disease modifying antirheumatic drug (DMARD) therapy in RETRO, a prospective randomised controlled trial. MBDA scores (scale 1–100) were determined based on 12 inflammation markers in baseline serum samples from 94 patients of the RETRO study. MBDA scores were compared between patients relapsing or remaining in remission when tapering DMARDs. Demographic and disease-specific parameters were included in multivariate logistic regression analysis for defining predictors of relapse. Moderate-to-high MBDA scores were found in 33% of patients with RA overall. Twice as many patients who relapsed (58%) had moderate/high MBDA compared with patients who remained in remission (21%). Baseline MBDA scores were significantly higher in patients with RA who were relapsing than those remaining in stable remission (N=94; p=0.0001) and those tapering/stopping (N=59; p=0.0001). Multivariate regression analysis identified MBDA scores as independent predictor for relapses in addition to anticitrullinated protein antibody (ACPA) status. Relapse rates were low (13%) in patients who were MBDA−/ACPA−, moderate in patients who were MBDA+/ACPA− (33.3%) and MBDA−ACPA+ (31.8%) and high in patients who were MBDA+/ACPA+ (76.4%). MBDA improved the prediction of relapses in patients with RA in stable remission undergoing DMARD tapering. If combined with ACPA testing, MBDA allowed prediction of relapse in more than 80% of the patients. EudraCT 2009-015740-42.
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影响因子：
3.7
作者：
Centola M;Cavet G;Shen Y;Ramanujan S;Knowlton N;Swan KA;Turner M;Sutton C;Smith DR;Haney DJ;Chernoff D;Hesterberg LK;Carulli JP;Taylor PC;Shadick NA;Weinblatt ME;Curtis JR
通讯作者：
Curtis JR
影响因子：
27.4
作者：
Haschka, Judith;Englbrecht, Matthias;Rech, Juergen
通讯作者：
Rech, Juergen
影响因子：
27.4
作者：
Bakker MF;Cavet G;Jacobs JW;Bijlsma JW;Haney DJ;Shen Y;Hesterberg LK;Smith DR;Centola M;van Roon JA;Lafeber FP;Welsing PM
通讯作者：
Welsing PM
影响因子：
--
作者：
van der Woude, Diane;Young, Adam;van der Helm-van Mil, Annette H. M.
通讯作者：
van der Helm-van Mil, Annette H. M.
影响因子：
--
作者：
Brown, A. K.;Conaghan, P. G.;Emery, P.
通讯作者：
Emery, P.