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Báo cáo y học: "Risk factors for radiographic progression in psoriatic arthritis: subanalysis of the randomized controlled trial ADEPT"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Risk factors for radiographic progression in psoriatic arthritis: subanalysis of the randomized controlled trial ADEPT. | Gladman et al. Arthritis Research Therapy 2010 12 R113 http arthritis-research.eom content 12 3 R113 RESEARCH ARTICLE Open Access Risklfactors for radiographic progression in psoriatic arthritis subanalysis of the randomized controlled trial ADEPT Dafna D Gladman1 Philip J Mease2 Ernest HS Choy3 Christopher T Ritchlin4 Renee J Perdok5 and Eric H Sasso 5 Abstract Introduction To identify independent predictors of radiographic progression in psoriatic arthritis PsA for patients treated with adalimumab or placebo in the Adalimumab Effectiveness in PsA Trial ADEPT . Methods Univariate analyses and multivariate linear regression analyses assessed risk for radiographic progression change in modified total Sharp score AmTSS 0.5 from baseline to week 24 for C-reactive protein CRP and other baseline variables and for 24-week time-averaged CRP univariate analysis only . Subanalyses determined mean AmTSS for CRP subgroups. Analyses were post hoc with observed data. Results One hundred and forty-four adalimumab-treated patients and 152 placebo-treated patients were assessed. Mean CRP was 64 lower by week 2 with adalimumab and essentially unchanged with placebo. Univariate analyses indicated that elevated CRP at baseline and time-averaged CRP were strongly associated with radiographic progression for placebo-treated patients but not for adalimumab-treated patients. Multivariate analysis confirmed that elevated baseline CRP was the only strong independent risk factor for radiographic progression for CRP 1.0 mg dl odds ratio 3.28 95 confidence interval 1.66 to 6.51 P 0.001 . Adalimumab treatment reduced risk of progression approximately fivefold. The difference between mean AmTSS for adalimumab versus placebo was greatest for patients with baseline CRP 2.0 mg dl -0.5 vs. 2.6 . Conclusions Systemic inflammation in PsA as indicated by elevated baseline CRP was the only strong independent predictor of radiographic progression. This association was observed predominantly for .