Time to achieve remission determines time to be in remission.
Time to achieve remission determines time to be in remission.
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DOI：
10.1186/ar3027
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发表时间：
2010
影响因子：
4.9
通讯作者：
Van Riel PL
中科院分区：
文献类型：
--
作者：
Schipper LG;Fransen J;den Broeder AA;Van Riel PL
虽然缓解目前是类风湿关节炎（RA）患者的治疗目标，但在日常实践中达到并维持缓解的患者数量仍然很少。提示早期缓解与缓解的可持续性有关。目的是研究缓解时间和缓解的可持续性之间的关系，在一个队列的早期RA患者治疗，根据日常实践。在这项研究中，使用了1985年至2005年期间纳入的Nijmegen RA初始队列患者（N = 753）的3年随访数据。患者在诊断（ACR标准）时入选，在每三个月一次的访视时进行系统评价，并根据日常实践进行治疗。根据疾病活动性评分（DAS）<1.6和ACR缓解标准定义缓解。持续缓解至少6个月视为持续缓解。通过Cox回归分析确定缓解时间的预测因素。采用纵向二元回归分析缓解时间与持续缓解的关系。N = 398（52%）例患者达到缓解，中位缓解时间为12个月。男性、年龄较小和基线DAS较低可预测快速达到缓解。有n = 142（36%）例患者出现持续缓解，这仅通过较短的至缓解时间确定。至缓解时间和持续缓解之间的关系通过显著比值比（1.11）（1.10至1.12-95% CI）描述，该比值比在整个1985年至2005年期间保持不变。ACR缓解标准的结果相似。较短的缓解时间与缓解的可持续性有关，支持RA患者争取早期缓解。
Though remission is currently a treatment goal in patients with rheumatoid arthritis (RA), the number of patients who achieve and sustain remission in daily practice is still small. It is suggested that early remission will be associated with sustainability of remission. The aim was to study the association between time-to-remission and sustainability of remission in a cohort of early RA patients treated according to daily practice. For this study, three-year follow-up data were used from the Nijmegen RA Inception Cohort of patients included between 1985 and 2005 (N = 753). Patients were included upon diagnosis (ACR criteria), were systematically evaluated at three-monthly visits and treated according to daily practice. Remission was defined according to the Disease Activity Score (DAS) <1.6 and the ACR remission criteria. Remission of at least 6 months duration was regarded as sustained remission. Predictors for time-to-remission were identified by Cox-regression analyses. The relation between time-to-remission and sustained remission was analyzed using longitudinal binary regression. N = 398 (52%) patients achieved remission with a median time-to-remission of 12 months. Male gender, younger age and low DAS at baseline were predictive to reach remission rapidly. There were n = 142 (36%) patients experiencing sustained remission, which was determined by a shorter time-to-remission only. The relationship between time-to-remission and sustained remission was described by a significant odds ratio (1.11) (1.10 to 1.12-95% CI) that was constant over the whole period 1985 to 2005. Results obtained with the ACR remission criteria were similar. A shorter time-to-remission is related to sustainability of remission, supporting striving for early remission in patients with RA.
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影响因子：
--
作者：
Aletaha, Daniel;Funovits, Julia;Smolen, Josef S.
通讯作者：
Smolen, Josef S.
影响因子：
--
作者：
Landewé, RBM;Boers, M;van der Linden, S
通讯作者：
van der Linden, S
影响因子：
--
作者：
Goekoop-Ruiterman, YPM;de Vries-Bouwstra, JK;Dijkmans, C
通讯作者：
Dijkmans, C
影响因子：
5.5
作者：
Kiely, Patrick D. W.;Brown, Andrew K.;Conaghan, Philip G.
通讯作者：
Conaghan, Philip G.
影响因子：
27.4
作者：
Gossec, L;Dougados, M;Combe, B
通讯作者：
Combe, B