Heart rate variability predicts anti-tumor necrosis factor therapy response for inflammatory arthritis
Heart rate variability predicts anti-tumor necrosis factor therapy response for inflammatory arthritis
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DOI：
10.1016/j.autneu.2008.05.005
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发表时间：
2008-12-05
影响因子：
2.7
通讯作者：
Ng, Edmund
中科院分区：
文献类型：
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作者：
Holman, Andrew J.;Ng, Edmund
为了考虑将自主神经状态作为炎症性关节炎抗肿瘤坏死因子（TNF）治疗反应的预测因子，我们进行了一项探索性研究。双盲。使用心率变异性（HRV）对33例类风湿关节炎（25例）或银屑病关节炎（8例）患者进行为期52周的研究。所有人都被评估了副交感神经，交感神经。用依那西普（15）或阿达木单抗（18）抗tnf治疗开始时的总功率和张力指数测量自主神经反应性。根据国际公认的结局标准（ACR20/50/70和DAS28反应）在6、12、26和52周时评估临床反应。所有HRV评估（p值范围0.001-0.032）都具有预测价值，除了交感反应（p值范围0.06-0.22）。ACR50和ACR70在52周和早在6周的一些措施。副交感神经和紧张指数预测DAS28预后（p值范围为0.009 ~ 0.024）。较差的抗tnf反应与低副交感神经、低总功率、高交感神经和高紧张指数测量相关，在先前的抗tnf失败亚群中也占主导地位（12）。总之，这项独特的探索性研究表明，HRV可能是炎症性关节炎患者抗tnf治疗反应的一种新的、有用的预测因子，并强调了自身免疫性疾病表达的自主神经影响的重要性。(C) 2008 Elsevier B.V.版权所有
To consider autonomic status as a predictor of anti-tumor necrosis factor (TNF) treatment response for inflammatory arthritis, we conducted an exploratory. double-blind. 52-week study with 33 patients with rheumatoid (25) or psoriatic (8) arthritis using heart rate variability (HRV). All were assessed for parasympathetic, sympathetic. total power and tension index measures of autonomic reactivity at initiation of anti-TNF therapy with etanercept (15) or adalimumab (18). Clinical response was assessed at 6,12, 26 and 52 weeks by internationally accepted outcome criteria (ACR20/50/70 and DAS28 response). Predictive value was demonstrated for all HRV assessments (p-value range 0.001-0.032), except sympathetic (p-value range 0.06-0.22), for ACR20. ACR50 and ACR70 at 52 weeks and at as early as 6 weeks for some measures. Only parasympathetic and tension index predicted DAS28 outcome (p-value range 0.009-0.024). Poor anti-TNF response was associated with low parasympathetic, low total power, high sympathetic and high tension index measures, a profile also predominant in the prior anti-TNF failure subset (12). In conclusion, this unique, exploratory study suggests that HRV may be a novel, useful predictor of response to anti-TNF therapy in patients with inflammatory arthritis, and emphasizes the importance of autonomic influence of autoimmune disease expression. (C) 2008 Elsevier B.V. All rights reserved.