Remission and low disease activity in a cohort of real-life patients with rheumatoid arthritis treated with first-line antitumour necrosis factor
Remission and low disease activity in a cohort of real-life patients with rheumatoid arthritis treated with first-line antitumour necrosis factor
复制标题
DOI：
10.1177/0300060515593262
复制
发表时间：
2016-09-01
影响因子：
1.6
通讯作者：
Perricone, Roberto
中科院分区：
文献类型：
--
作者：
Conigliaro, Paola;Chimenti, Maria Sole;Perricone, Roberto
目的以抗肿瘤坏死因子(抗肿瘤坏死因子)作为一线治疗类风湿关节炎(RA)患者，同时观察类风湿关节炎(RA)患者应用抗肿瘤坏死因子(抗肿瘤坏死因子)和常规抗风湿药物(CsDMARD)治疗后病情缓解和低活动度的变化。在强的松和csDMARD联合治疗的同时，在6个月、1年和2年后记录缓解和低疾病活动度。6个月后CDAI、SDAI和DAS28的缓解率分别为18.0%、20.3%和23.0%。1年和2年后，CDAI组缓解率分别为18.4%和15.9%，SDAI组分别为21.8%和17.3%，DAS28组分别为22.1%和17.3%。根据所用指数的不同，30-40%的患者疾病活跃度较低。在抗肿瘤坏死因子治疗过程中，使用泼尼松和csDMARDS的患者数量显著减少。结论在临床实践中，一线抗肿瘤坏死因子治疗的缓解是一个可以实现的目标，允许同时使用csDMARD和强的松治疗。
Objectives This retrospective study used various indices to evaluate remission and low disease activity in real life' patients with rheumatoid arthritis (RA), given antitumour necrosis factor (anti-TNF) as a first-line treatment; changes in concomitant steroid and conventional synthetic disease-modifying antirheumatic drug (csDMARD) treatment were also assessed.Methods Remission and low disease activity were analysed in patients with RA treated with anti-TNF using the 28-joint Disease Activity Score (DAS28), Simplified Disease Activity Index (SDAI) and Clinical Disease Activity Index (CDAI). Remission and low disease activity were recorded after 6 months, 1 year and 2 years, along with concomitant prednisone and csDMARD treatment.Results A total of 271 patients with RA were included in the study. After 6 months, remission rates were 18.0%, 20.3% and 23.0% as assessed by CDAI, SDAI and DAS28, respectively. After 1 year and 2 years, respectively, remission rates were 18.4% and 15.9% using CDAI, 21.8% and 17.3% using SDAI, and 22.1% and 17.3% using DAS28. Low disease activity was achieved in 30-40% of patients, depending on the indices used. There was a significant reduction in the number of patients on prednisone and csDMARDs during anti-TNF treatment.Conclusion Remission with first-line anti-TNF treatment is an achievable goal in clinical practice, allowing a reduction in concomitant csDMARD and prednisone treatment.