Defining Remission in Rheumatoid Arthritis：定义在类风湿关节炎缓解.pptVIP

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2017-08-31 发布于江西
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Defining Remission in Rheumatoid Arthritis：定义在类风湿关节炎缓解.ppt

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Defining Remission in Rheumatoid Arthritis：定义在类风湿关节炎缓解

* * * * * * * * * * * * * * * * * * * * * Indexes Tested DAS28 = 0.56*√(TJC28) + 0.28*√(SJC28) + 0.36*Ln(CRP*10 + 1) + 0.014*PtGA (0-100 scale)+ 0.96 Levels tested: DAS28 2.6; DAS28 2.0 SDAI (Simplified Disease Activity Index) = TJC28 + SJC28 + PtGA (0-10 scale) + PhGA (0-10) + CRP (mg/dL) Level tested: SDAI 3.3 Step 4: Predictive ValidityComparing the Candidate Definitions Does remission predict later good outcome? Remission at month 6 should predict good outcome for x-ray and HAQ between 12 and 24 months: X-ray - good outcome: change 0 in modSharp or Sharp-vdH score Function - good outcome: change 0 in HAQ and HAQ score 0.5 Remission? 6 mos 12 mos G o o d O u t c o m e ? 24 mos Validity of Candidate Remission Definitions: Predicting a Good Outcome for X-ray Percent in Remission with Good Outcome Percent NOT in Remission with Good Outcome Positive Likelihood Ratio P Value TJC28, SJC28, CRP ≤ 1 69% 50% 2.0 0.01 + PtGA ≤1 77% 51% 2.9 0.006 + Pain ≤1 74% 51% 2.6 0.01 + PhGA and PtGA 1 77% 51% 2.9 0.01 + PhGA and Pain ≤1 77% 51% 2.9 0.01 + PtGA and Pain ≤1 76% 51% 2.8 0.001 + PhGA, PtGA and Pain ≤1 76% 51% 2.8 0.02 Validity of Index Remission Definitions: Predicting a Good Outcome for X-ray Percent in Remission with Good Outcome Percent NOT in Remission with Good Outcome Positive Likelihood Ratio P Value TJC28, SJC28, CRP, PtGA ≤1 77% 51% 2.9 0.006 I N D E X E S DAS282.6 60% 59% 1.0 0.93 DAS282.0 70% 59% 1.6 0.48 SDAI≤3.3 77% 50% 3.0 0.003 Validity of Candidate Remission Definitions: Predicting a Good Outcome for Both X-ray and HAQ Percent in Remission with Good Outcome Percent NOT in Remission with Good Outcome Positive Likelihood Ratio P Value TJC28, SJC28, CRP ≤ 1 46% 17% 3.2 .0001 + PtGA ≤1 66% 17% 7.2 .0001 + Pain ≤1 60% 17% 5.7 .0001 + PhGA and PtGA 1 68% 17% 8.0 .0001 + PhGA and Pain ≤1 64% 18% 6.7 .0001 + PtGA and Pain ≤1 64% 17% 6.8 .0001 + Ph