Indexată BDI | IDB Indexed
A forum for responsible and ethical research publishing – Code of Conduct and Best Practice Guidelines for Journal Editors.
RJR și SRR oferă anual Premiul Național pentru Știință și Cercetare - pentru autorii celor mai bune articole științifice publicate [...]
Tema plagiatului este tot mai mult discutată în ultima vreme. Apariția unor programe performante de căutare și identificare a similitudinilor între texte [...]
CAN SDAI REMISSION BE PREDICTED IN PATIENTS WITH ESTABLISHED RHEUMATOID ARTHRITIS TREATED WITH ANTI-TNF AGENTS?
Objective. To identify predictors for Simplified Disease Activity Index (SDAI) remission in established rheumatoid arthritis (RA) and to develop a predictive score for remission.
Methods. Prospective 12-month observational study in ninety active RA receiving their first TNF-α inhibitor. Standard assessments consisted of disease activity scores (DAS28-ESR, SDAI) and immune parameters (total rheumatoid factor, RF; IGA-RF; anti-cyclic citrullinated peptide antibodies, ACPA). The primary outcome measure was SDAI remission (≤ 3.3) at 12 months. Univariate and multivariate logistic regression models were used to estimate association between baseline variables and SDAI remission.
Results. 39.7% RA achieved remission, while 56.8% low disease activity. Significant association between SDAI remission and RA-onset before 50 (p = 0.000), history <5 years (p = 0.000), stage (p = 0.000), class I and II Steinbroker functional status (p = 0.022), HAQ-DI≤2 (p = 0.034), CRP ≤ 20mg/l (p = 0.041), IgA-RF ≤ 20 IU/ml (p = 0.002), ACPA ≤ 40 IU/ml (p = 0.047), concomitant DMARDs (p = 0.003) were identified. Four parameters independently predicted 12-month remission (age at onset under 50, RA duration <5 years, ACPA≤40 IU/ml, IgA-RF ≤ 20 IU/ml) as demonstrated by multivariate logistic regression (p<0.05), making correct prediction in 84.4% patients. Furthermore, the remission score correctly classified 90.6% RA, while the transformed simplified version up to 89.4% cases. Gender, clinical parameters and ESR were not predictors for treatment response (p > 0.05).
Conclusion. SDAI remission can be predicted in established RA using a score based on age at onset, disease duration, titers of ACPA and RF isotype A. Such a simplified score may help clinicians to manage remission in RA patients according to the current treatment guidelines.
Keywords: anti-TNF agents, established rheumatoid arthritis, predictors, remission, SDAI
Full text | PDF