定义疾病活动状态的目标BASDAI截止值和轴性脊柱关节炎的改善得分:一个多中心合作
Rudra Prosad Goswami1, Moumita Chatterjee2, Shyamashis Das3
1Department of Rheumatology, All India Institute of Medical Sciences, New Delhi, India.
International journal of rheumatic diseases
|November 18, 2024
概括
这项研究建立了新的Bath缩脊柱炎疾病活动指数 (BASDAI) 截止值,与缩脊柱炎疾病活动得分与CRP (ASDAS) 水平和变化相对应. 这些发现有助于在轴性脊柱关节炎 (axSpA) 中标准化疾病活性评估.
科学领域:
- 风湿病学和免疫学
- 临床试验分析
- 生物标志物的验证
背景情况:
- 准确评估疾病活动对于管理轴性脊柱关节炎 (axSpA) 至关重要.
- 浴性脊髓炎疾病活动指数 (BASDAI) 和带有CRP的脊髓炎疾病活动得分 (ASDAS) 是关键指标.
- 建立这些指数之间的直接相关性可以改善临床实践和研究.
研究的目的:
- 确定与已建立的ASDAS-CRP截止值 (1.3,2.1,3.5) 保持一致的客观BASDAI截止值.
- 定义区间变化BASDAI (ΔBASDAI) 值,对应于1.1和2的ASDAS-CRP区间变化 (ΔASDAS).
- 提供一种更统一的方法来监测axSpA患者的疾病活性.
主要方法:
- 一项多中心研究分析了成人axSpA患者的BASDAI和ASDAS数据,这些患者接受了托法西提尼布或阿达利穆马布治疗.
- 用多项和顺序逻辑回归分析了对间隔变化数据 (间隔≥3个月).
- 使用正确的分类率 (CRR),多色相关性 (PCC),古德曼和克鲁斯卡尔马 (GKG) 和马修的相关系数 (MCC) 来评估诊断准确度.
主要成果:
- 分析了266名患者的数据 (962个配对观察,670个间隔变化).
- 派生的BASDAI截止值为0.8,2.5和6,对应于1.3,2.1和3.5.5的ASDAS值.
- 2 和 4 的 ΔBASDAI 切线与分别为 1.1 和 2 的 ΔASDAS 值相对应,具有高的 PCC 和 GKG 值.
结论:
- 目标BASDAI切线值为0.8,2.5和6,准确地反映了axSpA.中的非活性,中度和高疾病活性的ASDAS-CRP值.
- 2和4的DBASDAI值实际上与ASDAS-CRP的临床显著变化相对应.
- 这些经过验证的BASDAI切断值可以提高 axSpA.中的疾病活性和治疗反应的一致评估.
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