在治疗银屑病关节炎患者过程中达到可接受的健康相关生活质量的相关因素

P. Tremaskina, T. Korotaeva, E. Loginova, S. Glukhova, A. Lila
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Over time, a standard rheumatological examination was performed. Activity of PsA was assessed by DAPSA, psoriasis by BSA, HRQoL by Psoriatic Arthritis Impact of Disease (PsAID-12); body mass index (BMI, kg/m2 ) and functional status by HAQ were also assessed. PsAID-12 ≤4 corresponded to achieving a Patient Acceptable State Status (PASS). The results were analyzed in two groups of patients: PsAID-12 ≤4 and PsAID-12 >4. The number of patients (%) who achieved minimal disease activity (MDA) after 1–2 years of active treatment and after 7 years was assessed. X-rays of the hands and feet (n=42) were performed using standard methods, changes were assessed using the Sharp/van der Heijde method modified for PsA (m-Sharp/van der Heijde).Results and discussion. After 7 years, 38 (71.7%) of 53 patients were found to have PASS. 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引用次数: 0

摘要

目的:分析银屑病关节炎(PsA)患者在开始观察7年后达到可接受的健康相关生活质量(HRQoL)的相关因素。研究纳入了符合2006年CASPAR标准的53名PsA患者(28名女性,25名男性)。患者的平均年龄为(45.7±12.0)岁,中位 PsA 病程为 90 [72; 99] 个月,观察期为 81 [61; 91] 个月。研究对象包括 PsA 早期患者(病程不超过 2 年),他们接受了为期 24 个月的 "靶向治疗 "策略(T2T)。随后,所有患者在主治医生的指导下继续按照医疗标准接受治疗。随着时间的推移,还进行了标准的风湿病检查。PsA活动度由DAPSA评估,银屑病由BSA评估,HRQoL由银屑病关节炎对疾病的影响(PsAID-12)评估;体重指数(BMI,kg/m2)和功能状态由HAQ评估。PsAID-12 ≤4相当于达到患者可接受状态(PASS)。对两组患者的结果进行了分析:评估了在积极治疗 1-2 年和 7 年后达到最小疾病活动度(MDA)的患者人数(%)。采用标准方法对手部和足部(n=42)进行了X光检查,并采用针对PsA修改的夏普/范德海德法(m-Sharp/van der Heijde)对变化进行了评估。7 年后,53 名患者中有 38 人(71.7%)达到了 PASS。达到 PASS 的患者 PsA 和银屑病活动度明显降低,CRP 水平降低,m-Sharp/van der Heijde 评分降低,功能状态和 HRQoL 改善,基线体重指数降低。与达到PASS相关的因素包括:无指甲银屑病、BSA≤3%、CRP≤5 mg/l、肿胀关节数≤3、疼痛关节数≤5、基线和24个月后HAQ≤0.5,以及在治疗的前12个月达到MDA。大多数根据T2T原则接受早期治疗的PsA患者都有PASS,这与低疾病活动度、较少关节侵蚀、较好的功能状态以及在治疗的前12个月达到MDA有关。在预测疾病进展时应考虑这些因素。
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Factors associated with achieving an acceptable health-related quality of life in the treatment of patients with psoriatic arthritis
Objective: to analyze factors associated with the achievement of acceptable health-related quality of life (HRQoL) in patients with psoriatic arthritis (PsA) 7 years after the start of observation.Material and methods. The study included 53 patients (28 women, 25 men) with PsA who met the 2006 CASPAR criteria. The mean age of patients was 45.7±12.0 years, the median duration of PsA was 90 [72; 99] months, and the observation period was 81 [61; 91] months. The study included patients in early stage of PsA (duration up to 2 years), who were treated according to the “treat-to-target” strategy (T2T) for 24 months. Subsequently, all patients continued therapy according to the standards of medical care under the supervision of the treating physician. Over time, a standard rheumatological examination was performed. Activity of PsA was assessed by DAPSA, psoriasis by BSA, HRQoL by Psoriatic Arthritis Impact of Disease (PsAID-12); body mass index (BMI, kg/m2 ) and functional status by HAQ were also assessed. PsAID-12 ≤4 corresponded to achieving a Patient Acceptable State Status (PASS). The results were analyzed in two groups of patients: PsAID-12 ≤4 and PsAID-12 >4. The number of patients (%) who achieved minimal disease activity (MDA) after 1–2 years of active treatment and after 7 years was assessed. X-rays of the hands and feet (n=42) were performed using standard methods, changes were assessed using the Sharp/van der Heijde method modified for PsA (m-Sharp/van der Heijde).Results and discussion. After 7 years, 38 (71.7%) of 53 patients were found to have PASS. Patients who achieved PASS had significantly lower PsA and psoriasis activity, lower CRP levels, lower m-Sharp/van der Heijde scores, better functional status and HRQoL, and lower BMI at baseline. Factors associated with achieving PASS were identified: absence of nail psoriasis, BSA ≤3%, CRP ≤5 mg/l, number of swollen joints ≤3, number of painful joints ≤5, HAQ ≤0.5 at baseline and after 24 months, and achievement of MDA during the first 12 months of treatment.Conclusion. The majority of PsA patients treated at an early stage according to T2T principles had PASS, which is associated with low disease activity, fewer joint erosions, better functional status and achievement of MDA during the first 12 months of therapy. These factors should be considered when predicting disease progression.
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