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首页> 外文期刊>European journal of clinical investigation >Influence of baseline modified Rheumatic Disease Comorbidity Index ( mRDCI mRDCI ) on drug survival and effectiveness of biological treatment in patients affected with Rheumatoid arthritis, Spondyloarthritis and Psoriatic arthritis in real‐world settings
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Influence of baseline modified Rheumatic Disease Comorbidity Index ( mRDCI mRDCI ) on drug survival and effectiveness of biological treatment in patients affected with Rheumatoid arthritis, Spondyloarthritis and Psoriatic arthritis in real‐world settings

机译：基线改性风湿性疾病合并症（MRDCI MRDCI）对类风湿性关节炎，脊椎炎和人对人类关节炎的患者药物存活率及生物治疗的有效性

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Abstract Aim To assess the impact of baseline modified Rheumatic Disease Comorbidity Index ( m RDCI ) a simple comorbidity count, on overall survival of treatments with biological drugs in patients affected with Rheumatoid Arthritis ( RA ), Spondyloarthritis (SpA) and Psoriatic Arthritis (PsA) in real‐world settings. Methods Patients (nr. 635) with RA (nr. 214), SpA (nr. 213) and PsA (nr. 208) starting a first biological drug were retrospectively analysed. mRDCI was scored at baseline, and disease characteristics were recorded at entry and at last observation. Drug retention was analysed using Kaplan‐Meier curves. Cox regression models were used to estimate the association of baseline mRDCI with drug discontinuation and clinical outcomes, the achievement of clinical remission based on 28 joint‐Disease Activity Score ( DAS 28) 2.6 for RA and PsA, and on Ankylosing Spondylitis‐C‐reactive protein Disease Activity Score ( ASDAS ‐ CRP ) 1.3 for SpA. Results Baseline mRDCI significantly correlated with the number of biological drug switches ( rho 0.26). Persistence on biologic therapy was significantly higher in patients with mRDCI =0 (96.4%), than in those with mRDCI ≥2 (83.9%). Patients without comorbidities showed significantly higher drug survival rate in PsA ( P ?=?0.0001) or SpA ( P ?=?0.02), but not in RA . mRDCI was also found to be a predictor of definitive drug discontinuation ( HR : 1.53) and of failure to achieve remission in RA ( HR : 0.66) or PsA ( HR : 0.77), and in SpA ( HR : 0.43). Conclusions This study provided evidence that baseline m RDCI negatively impacts the persistence on biologic treatments and clinical outcomes in patients with RA , SpA and PsA in real‐life settings.
机译：摘要旨在评估基线改性风湿病合并症（M RDCI）一种简单的合并症的影响，患有类风湿性关节炎（RA），脊椎细胞炎（SPA）和银屑病关节炎（PSA）的患者治疗患者治疗的整体存活率在现实世界的环境中。方法患者（NR。635）用RA（NR.214），回顾性分析第一种生物药物的SPA（NR。213）和PSA（NR。208）。 MRDCI在基线评分，疾病特征在进入和最后观察中记录。使用Kaplan-Meier曲线分析药物保留。 Cox回归模型用于估算基线MRDCI与药物停止和临床结果的关联，基于28次关节疾病活动评分（DAS 28）为RA和PSA的临床缓解，以及强直性脊柱炎-C - 用于水疗中心的蛋白质疾病活动评分（ASDAS - CRP）＆ 1.3。结果基线MRDCI与生物药物开关的数量显着相关（RHO 0.26）。 MRDCI = 0（96.4％）的患者的生物治疗持续性显着高于MRDCI≥2（83.9％）。没有合并症的患者在PSA中显示出明显更高的药物存活率（P？= 0.0001）或水疗中心（P？= 0.02），但不在RA中。也发现MRDCI是最终药物停止（HR：1.53）的预测因子，并且在RA（HR：0.66）或PSA（HR：0.77）和SPA中达到缓解（HR：0.43）。结论本研究规定了证据表明，基线M RDCI对现实生活中的RA，SPA和PSA患者的生物治疗和临床结果产生了负面影响。

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