Impact of Orthopedic Surgical Intervention on Difficult-to-Treat Rheumatoid Arthritis: A Propensity Score Matched Study.

IF 1.8 4区 医学 Q3 RHEUMATOLOGY Modern Rheumatology Pub Date : 2024-10-29 DOI:10.1093/mr/roae097
Shogo Toyama, Hajime Ishikawa, Asami Abe, Nariaki Hao, Hiroshi Otani, Sayuri Takamura, Masanori Sudo, Satoshi Ito, Kiyoshi Nakazono, Ryo Oda, Kenji Takahashi, Akira Murasawa
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Abstract

Objective: To elucidate the therapeutic effect of orthopedic surgical intervention (OSI) in difficult-to-treat rheumatoid arthritis (D2T RA) compared with non-D2T RA.

Methods: A total of 534 recent surgeries were analyzed only in patients who had undergone OSI since 2016 and for whom a 12-month post-operative follow-up was available. D2T RA was determined according to the EULAR definition, and patients with D2T RA were matched to patients with non-D2T RA using propensity scores calculated by a logistic regression analysis. The Health Assessment Questionnaire-Disability Index (HAQ-DI), Disease Activity Index 28 (DAS28), face scale, and patient's assessment of general health (GH) were measured repeatedly at baseline and 6 and 12 months and were compared using a two-way analysis of variance.

Results: The HAQ-DI, DAS28, face scale, and GH showed significant post-operative improvements, and there were significant differences in the HAQ-DI and face scale scores between D2T RA and non-D2T RA. An additional analysis with DAS28 as a covariate showed no significant interaction for either, suggesting that these improvements in clinical assessment were due to OSI rather than improved disease activity.

Conclusions: In the absence of an effective pharmacological treatment strategy, OSI may be an effective treatment modality for the management of D2T RA.

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骨科手术干预对难以治疗的类风湿关节炎的影响:倾向得分匹配研究
目的与非D2T类风湿关节炎相比,阐明骨科手术干预(OSI)对难治类风湿关节炎(D2T RA)的治疗效果:仅分析了自2016年以来接受过OSI手术且有12个月术后随访记录的534例近期手术患者。根据EULAR定义确定D2T RA,并通过逻辑回归分析计算倾向得分,将D2T RA患者与非D2T RA患者进行配对。在基线期、6个月和12个月时反复测量健康评估问卷-残疾指数(HAQ-DI)、疾病活动指数28(DAS28)、面容量表和患者一般健康评估(GH),并采用双向方差分析进行比较:结果:HAQ-DI、DAS28、面相量表和GH在术后均有显著改善,D2T RA和非D2T RA的HAQ-DI和面相量表得分存在显著差异。以DAS28作为协变量的附加分析显示,两者之间没有显著的交互作用,这表明临床评估的改善是由于OSI而非疾病活动的改善:结论:在缺乏有效药物治疗策略的情况下,OSI可能是治疗D2T RA的一种有效治疗方式。
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来源期刊
Modern Rheumatology
Modern Rheumatology RHEUMATOLOGY-
CiteScore
4.90
自引率
9.10%
发文量
146
审稿时长
1.5 months
期刊介绍: Modern Rheumatology publishes original papers in English on research pertinent to rheumatology and associated areas such as pathology, physiology, clinical immunology, microbiology, biochemistry, experimental animal models, pharmacology, and orthopedic surgery. Occasional reviews of topics which may be of wide interest to the readership will be accepted. In addition, concise papers of special scientific importance that represent definitive and original studies will be considered. Modern Rheumatology is currently indexed in Science Citation Index Expanded (SciSearch), Journal Citation Reports/Science Edition, PubMed/Medline, SCOPUS, EMBASE, Chemical Abstracts Service (CAS), Google Scholar, EBSCO, CSA, Academic OneFile, Current Abstracts, Elsevier Biobase, Gale, Health Reference Center Academic, OCLC, SCImago, Summon by Serial Solutions
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