risk factors for radiographic progression in psoriatic arthritis subanalysis of the randomized controlled trial adept影像学进展的风险因素在银屑病关节炎的随机对照试验subanalysis娴熟.pdfVIP

Gladman et al. Arthritis Research Therapy 2010, 12:R113 /content/12/3/R113 R E S E A R C H A R T I C L E Open Access Research article Risk factors for radiographic progression in psoriatic arthritis: subanalysis of the randomized controlled trial ADEPT 1 2 3 4 5 5 Dafna D Gladman , Philip J Mease , Ernest HS Choy , Christopher T Ritchlin , Renee J Perdok and Eric H Sasso* 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, ΔmTSS 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 ΔmTSS 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