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首页> 外文期刊>Rheumatology >Is pre-assessment for anti-TNF therapy in RA necessary in the UK? Analysis of DAS28 in six centres.
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Is pre-assessment for anti-TNF therapy in RA necessary in the UK? Analysis of DAS28 in six centres.

机译：在英国是否需要对RA中的抗TNF治疗进行预评估？在六个中心对DAS28进行分析。

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OBJECTIVES: National Institute for Health and Clinical Excellence (NICE) guidelines for anti-tumour necrosis factor (TNF) in rheumatoid arthritis (RA) state that two pre-assessments of Disease Activity Score (DAS28) should be performed a month apart. We performed a retrospective audit of data from six centres to determine the stability of DAS28 between assessments, and the proportion of patients still satisfying eligibility criteria at baseline. METHODS: All RA patients assessed for anti-TNF from six centres had their pre-assessment DAS28 (DAS-1) compared with their baseline DAS28 (DAS0) using paired t-tests, and a similar analysis for the components of the DAS28. Patients who were no longer eligible for anti-TNF at DAS0 were noted. RESULTS: Six hundred and seventy-nine RA patients showed no significant change in the DAS28, with a mean DAS-1 of 6.74 and DAS0 of 6.73. (P = 0.86). Of the patients, 97.2% fulfilled the UK eligibility criteria at DAS0. Comparison of the individual components of the DAS28 between the two pre-assessment dates showed that there was no significant difference between either the numbers of swollen joints or the erythrocyte sedimentation rate (ESR), but there was a significant increase in the numbers of tender joints of 1.41 (P < 0.001) and in the visual analogue scale (VAS) of 4.22 (P < 0.001). DISCUSSION: The overwhelming majority of patients who fulfil eligibility criteria for anti-TNF drugs 1 month prior to baseline also fulfil the criteria at baseline. There is no significant change in the DAS28 over the month waiting to go onto anti-TNF therapy. A single assessment of the DAS28 would suffice to enable patients to go on to anti-TNF treatment.
机译：目的：美国国立卫生研究院（NICE）关于类风湿性关节炎（RA）中抗肿瘤坏死因子（TNF）的指南规定，疾病活动度评分（DAS28）的两个预评估应每月进行一次。我们对来自六个中心的数据进行了回顾性审核，以确定评估之间DAS28的稳定性以及基线时仍符合入选标准的患者比例。方法：使用配对t检验对所有六个中心进行抗TNF评估的RA患者进行了预先评估DAS28（DAS-1）与基线DAS28（DAS0）的比较，并对DAS28的成分进行了类似的分析。注意到在DAS0不再符合抗TNF资格的患者。结果：679例RA患者的DAS28无明显变化，平均DAS-1为6.74，DAS0为6.73。 （P ＝ 0.86）。在这些患者中，有97.2％符合DAS0的UK资格标准。比较两个预评估日期之间DAS28的各个组件，发现关节肿胀数目或红细胞沉降率（ESR）均无显着差异，但嫩关节数目显着增加1.41（P <0.001）和视觉模拟量表（VAS）4.22（P <0.001）。讨论：绝大多数在基线前1个月符合抗TNF药物资格标准的患者也符合基线标准。等待接受抗TNF治疗的当月DAS28没有明显变化。对DAS28进行一次评估就足以使患者继续接受抗TNF治疗。

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