Validation of the 28-joint Disease Activity Score (DAS28) and European League Against Rheumatism response criteria based on C-reactive protein against disease progression in patients with rheumatoid arthritis, and comparison with the DAS28 based on erythrocyte sedimentation rate.
Validation of the 28-joint Disease Activity Score (DAS28) and European League Against Rheumatism response criteria based on C-reactive protein against disease progression in patients with rheumatoid arthritis, and comparison with the DAS28 based on erythrocyte sedimentation rate.
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DOI：
10.1136/ard.2007.084459
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发表时间：
2009-06
影响因子：
27.4
通讯作者：
van Riel PL
中科院分区：
文献类型：
--
作者：
Wells G;Becker JC;Teng J;Dougados M;Schiff M;Smolen J;Aletaha D;van Riel PL
验证并比较基于C反应蛋白（DAS 28（CRP））的疾病活动性评分28定义与基于红细胞沉降率（ESR）的定义。数据分析来自两项随机、双盲、安慰剂对照的阿巴西普治疗类风湿性关节炎患者的试验，为期6个月和12个月。检查欧洲抗风湿联盟（EULAR）反应标准和基于两种DAS 28定义的缓解（DAS 28 <2.6）患者比例。分析了EULAR应答状态（无、中度和良好）的放射学进展（侵蚀评分、关节间隙狭窄评分和总评分）和身体功能（健康评估问卷残疾指数（HAQ-DI））趋势。使用两种DAS 28定义确定EULAR应答者状态的结果基本一致（κ = 0.80，95% CI 0.76 - 0.83）。 总体而言，EULAR缓解标准的一致率为82.4%;当发生不一致时，DAS 28（CRP）产生的EULAR缓解比DAS 28（ESR）更好（分别为12.6%和4.9%）。在确定缓解方面也存在一致性：κ = 0.69（95% CI 0.60 - 0.78）。 根据这两种定义，接受阿巴西普治疗的患者在EULAR状态（从无到中度到良好）之间的放射学进展减少。对于接受安慰剂治疗的患者，这种趋势并不明显，中度缓解者的放射学评分高于无缓解者。对于身体功能，在两个DAS 28定义的EULAR状态中观察到相似的趋势。DAS 28（CRP）已针对放射学进展和身体功能进行了验证。虽然DAS 28（CRP）比DAS 28（ESR）更常产生更好的EULAR应答，但验证特征与DAS 28（ESR）相似，表明两种测量方法均适用于评估类风湿性关节炎患者的疾病活动性。
To validate and compare the definition of the Disease Activity Score 28 based on C-reactive protein (DAS28 (CRP)) to the definition based on erythrocyte sedimentation rate (ESR). Data were analysed from two randomised, double-blind, placebo-controlled trials of abatacept of 6-month and 12-month duration in patients with rheumatoid arthritis. European League Against Rheumatism (EULAR) response criteria and the proportion of patients in remission (DAS28 <2.6) based on the two DAS28 definitions were examined. Trends in radiographic progression (erosion score, joint space narrowing score and total score) and physical function (Health Assessment Questionnaire Disability Index (HAQ-DI)) across the EULAR responder states (none, moderate and good) were analysed. There was general agreement in determining the EULAR responder state using both DAS28 definitions (κ = 0.80, 95% CI 0.76 to 0.83). Overall, there was 82.4% agreement on the EULAR response criteria; when disagreements occurred, the DAS28 (CRP) yielded a better EULAR response more often then DAS28 (ESR) (12.6% vs 4.9%, respectively). There was also agreement in determining remission: κ = 0.69 (95% CI 0.60 to 0.78). Radiographic progression decreased in patients treated with abatacept across EULAR states (from none to moderate to good) based on both definitions. For patients treated with placebo, the trend was not as pronounced, with radiographic scores higher for moderate vs non-responders. For physical function, similar trends were observed across the EULAR states for both DAS28 definitions. The DAS28 (CRP) has been validated against radiographic progression and physical function. While the DAS28 (CRP) yielded a better EULAR response more often than the DAS28 (ESR), the validation profile was similar to the DAS28 (ESR), indicating that both measures are useful for assessing disease activity in patients with rheumatoid arthritis.
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影响因子：
4.9
作者：
Vander Cruyssen B;Van Looy S;Wyns B;Westhovens R;Durez P;Van den Bosch F;Veys EM;Mielants H;De Clerck L;Peretz A;Malaise M;Verbruggen L;Vastesaeger N;Geldhof A;Boullart L;De Keyser F
通讯作者：
De Keyser F
影响因子：
158.5
作者：
Genovese, MC;Becker, J;Dougados, M
通讯作者：
Dougados, M
影响因子：
27.4
作者：
Inoue, Eisuke;Yamanaka, Hisashi;Kamatani, Naoyuki
通讯作者：
Kamatani, Naoyuki
影响因子：
27.4
作者：
Weinblatt, M. E.;Keystone, E. C.;Segurado, O. G.
通讯作者：
Segurado, O. G.
影响因子：
5.9
作者：
GENANT, HK
通讯作者：
GENANT, HK