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Ann Rheum Dis:青少年特发性关节炎的评估标准比较研究

2017-05-09 tianxuexin MedSci原创

针对青少年特发性关节炎(JIA)已经提出了临床上无症状疾病(CID)和最小疾病活动(MDA)的许多标准。这些标准在单个患者队列中有何种程度的重叠目前还不是特别清楚。本研究旨在比较青少年特发性关节炎在儿童队列中不同标准下的MDA和CID评估效果。

针对青少年特发性关节炎(JIA)已经提出了临床上无症状疾病(CID)和最小疾病活动(MDA)的许多标准。这些标准在单个患者队列中有何种程度的重叠目前还不是特别清楚。本研究旨在比较青少年特发性关节炎在儿童队列中不同标准下的MDA和CID评估效果。

本项儿童关节炎前瞻性研究在英国七个儿科和青少年风湿病初步报告中招募儿童(2001年10月至2013年12月期间的儿童)。使用由四个研究者定义、公布8次的复合标准来计算1年内这些JIA儿童发生CID和MDA的比例。在不同假设条件下,使用多次插补来计算缺失数据。

在1415名儿童和青少年的队列中,67%的患者在1年内没有活动性关节病变。 使用公布的标准评估:48%至61%达到MDA,25%至38%达到CID。标准之间的重叠有所不同。通过原始复合标准的922例MDA患者,青少年关节炎疾病活动评分(JADAS)或临床JADAS临界值,68%可以被所有3个标准分类为MDA。同样地,根据两项标准,由华莱士初步标准或JADAS临界标准确定的633例CID儿童中有44%来自CID。

该大型JIA预期前瞻性队列实验结论表明,大多数患者在1年后有持续性疾病活动的表征。一些发布的评估MDA和CID的标准并不都能识别同一组患者。这项研究的结论在未来制定治疗方案时具有重大意义。

原始出处:

Stephanie J W Shoop-Worrall, et al. How common is clinically inactive disease in a prospective cohort of patients with juvenile idiopathic arthritis? The importance of definition. Annals of the RheumaticDiseases.Published online 8 May 2017.. doi: 10.1136/annrheumdis-2016-210511

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    2017-05-15 1e145228m78(暂无匿称)

    学习了,谢谢作者分享!

    0

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    2017-05-12 138****1711

    学习了,谢谢分享!

    0

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    2017-05-11 lmm397

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