Perception of improvement in patients with rheumatoid arthritis varies with disease activity levels at baseline.
Perception of improvement in patients with rheumatoid arthritis varies with disease activity levels at baseline.
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DOI：
10.1002/art.24282
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发表时间：
2009-03-15
影响因子：
--
通讯作者：
Kvien, T. K.
中科院分区：
文献类型：
--
作者：
Aletaha, D.;Funovits, J.;Ward, M. M.;Smolen, J. S.;Kvien, T. K.
使用患者衍生锚点分析类风湿关节炎（RA）疾病活动指标的最小临床重要改善（MCII），并评估改善标准是否与基线疾病活动不同。我们使用了来自挪威观察数据库的数据，该数据库包括1，050例患者（73%为女性，65%为类风湿因子阳性，RA平均病程为7.7年）。在开始治疗后3个月，患者指出他们的病情是否改善、显著改善、不变、恶化或显著恶化。我们使用受试者工作特征曲线分析来确定基于28个关节评估的疾病活动性评分（DAS 28）、简化疾病活动性指数（SDAI）和临床疾病活动性指数（CDAI）的MCII，并分析不同基线疾病活动性水平对MCII的影响。平均而言，患者开始时疾病活动度较高，在治疗期间显著改善（美国流变学会20%，50%和70%改善标准反应分别为37%，17%和5%）。的总体平均DAS 28、SDAI和CDAI 3个月后MCII的阈值（95%置信区间[95% CI]）为1.20（95% CI 1.18-1.22），10.95（95% CI 10.69-11.20）和10.76（95% CI 10.49-11.04），主要缓解的平均（95% CI）阈值为1.82（95% CI 1.80-1.83）、15.82（95% CI 15.65-16.00）和15.00（95% CI 14.82-15.18）。随着疾病活动性的增加，根据患者的判断，需要更高的疾病活动性变化才能实现MCII。RA患者对疾病活动性改善的感知因其开始时的疾病活动性水平而异。
To analyze the minimum clinically important improvement (MCII) of disease activity measures in rheumatoid arthritis (RA) using patient-derived anchors, and to assess whether criteria for improvement differ with baseline disease activity. We used data from a Norwegian observational database comprising 1,050 patients (73% women, 65% rheumatoid factor-positive, mean duration of RA 7.7 years). At 3 months after initiation of therapy, patients indicated whether their condition had improved, had considerably improved, was unchanged, had worsened, or had considerably worsened. We used receiver operating characteristic curve analysis to determine the MCII for the Disease Activity Score based on the assessment of 28 joints (DAS28), the Simplified Disease Activity Index (SDAI), and the Clinical Disease Activity Index (CDAI), and analyzed the effects of different levels of baseline disease activity on the MCII. On average, patients started with high disease activity and improved significantly during treatment (American College of Rheumatology 20%, 50%, and 70% improvement criteria responses were 37%, 17%, and 5%, respectively). The overall mean (95% confidence interval [95% CI]) thresholds for MCII after 3 months for the DAS28, SDAI, and CDAI were 1.20 (95% CI 1.18–1.22), 10.95 (95% CI 10.69–11.20), and 10.76 (95% CI 10.49–11.04), respectively, and the mean (95% CI) thresholds for major responses were 1.82 (95% CI 1.80–1.83), 15.82 (95% CI 15.65–16.00), and 15.00 (95% CI 14.82–15.18), respectively. With increasing disease activity, much higher changes in disease activity were needed to achieve MCII according to patient judgment. The perception of improvement of disease activity of patients with RA is considerably different depending on the disease activity level at which they start.
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影响因子：
4.9
作者：
Aletaha D;Nell VP;Stamm T;Uffmann M;Pflugbeil S;Machold K;Smolen JS
通讯作者：
Smolen JS
影响因子：
--
作者：
Aletaha, Daniel;Funovits, Julia;Smolen, Josef S.
通讯作者：
Smolen, Josef S.
DOI：
10.1002/art.24123
发表时间：
2008-10-15
期刊：
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH
影响因子：
--
作者：
Aletaha, D.;Landewe, R.;Felson, D.
通讯作者：
Felson, D.
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：
27.4
作者：
Heiberg, T.;Kvien, T. K.;Hagen, K. B.
通讯作者：
Hagen, K. B.