Subscribe to RSS
DOI: 10.1055/s-0029-1225369
© Georg Thieme Verlag KG Stuttgart · New York
Rheumatoide Arthritis – Warum sind Joint Counts wichtig?
Rheumatoid Arthritis – Why are Joint Counts Important?Publication History
Publication Date:
07 July 2009 (online)
Zusammenfassung
Die rheumatoide Arthritis (RA) ist eine vielschichtige Erkrankung, deren Krankheitsaktivität durch verschiedenste Parameter widergespiegelt wird. Globalscores durch den Arzt oder Patienten, Schmerzskalen oder Akutphaseparameter sind valide Methoden zur Beurteilung der Krankheitsaktivität der RA. Die Gelenke jedoch stellen das Zielorgan der Erkrankung dar, daher ist die Beurteilung der Gelenke hinsichtlich Schwellung und Druckschmerzhaftigkeit die zentrale und am wenigsten verfälschte Methode zur Beurteilung der Krankheitsaktivität der RA. Joint Counts sollten daher in keinem Fall fehlen. Idealerweise jedoch sollten mehrere der erwähnten Parameter kombiniert beurteilt werden, um die höchste Verlässlichkeit des Ergebnisses zu erzielen. Dies kann durch die Verwendung von Indizes ermöglicht werden.
Abstract
Rheumatoid arthritis (RA) is a multi-faceted disease. The disease activity of RA can be assessed by using various measures. The patient's and physician's global assessments of disease activity, pain scores, and acute phase measures are all valid methods to assess disease activity. However, the joints are the target organ of arthritis and, therefore, assessment of joint activity is the most direct and unbiased method to evaluate RA disease activity. Joint Counts should therefore not be omitted at any single occasion of disease activity assessment. Ideally, however, several of the mentioned measures should be used in a combined way to allow for the most reliable results. This can be achieved by using composite indices.
Schlüsselwörter
rheumatoide Arthritis - Joint Counts - Endpunkte
Key words
rheumatoid arthritis - joint counts - outcomes
Literatur
- 1 Aletaha D, Smolen JS. The definition and measurement of disease modification in inflammatory rheumatic diseases. Rheum Dis Clin North Am. 2006; 32 9-44
- 2 Pincus T, Wolfe F. An infrastructure of patient questionnaires at each rheumatology visit: improving efficiency and documenting care. J Rheumatol. 2000; 27 2727-2730
- 3 Heiberg T, Kvien TK. Preferences for improved health examined in 1 024 patients with rheumatoid arthritis: pain has highest priority. Arthritis Rheum. 2002; 47 391-397
- 4 van Leenwen MA, van der Heijde DM, van Rijswijk MH. et al . Interrelationship of outcome measures and process variables in early rheumatoid arthritis. A comparison of radiologic damage, physical disability, joint counts, and acute phase reactants. J Rheumatol. 1994; 21 425-429
- 5 van Leeuwen MA, van Rijswijk MH, van der Heijde DM. et al . The acute-phase response in relation to radiographic progression in early rheumatoid arthritis: a prospective study during the first three years of the disease. Br J Rheumatol. 1993; 32 ((Suppl 3)) 9-13
- 6 Aletaha D, Nell VP, Stamm T. et al . Acute phase reactants add little to composite disease activity indices for rheumatoid arthritis: validation of a clinical activity score. Arthritis Res Ther. 2005; 7 R796-R806
- 7 Aletaha D, Smolen J, Ward MM. Measuring function in rheumatoid arthritis: Identifying reversible and irreversible components. Arthritis Rheum. 2006; 54 2784-2792
- 8 Aletaha D, Funovits J, Breedveld FC. et al . Rheumatoid arthritis joint progression in sustained remission is determined by disease activity levels preceding the period of radiographic assessment. Arthritis Rheum. 2009; 60 1242-1249
- 9 Lard LR, Visser H, Speyer I. et al . Early versus delayed treatment in patients with recent-onset rheumatoid arthritis: comparison of two cohorts who received different treatment strategies. Am J Med. 2001; 111 446-451
- 10 Nell VP, Machold KP, Eberl G. et al . Benefit of very early referral and very early therapy with disease-modifying anti-rheumatic drugs in patients with early rheumatoid arthritis. Rheumatology (Oxford). 2004; 43 906-914
- 11 van der Heide A, Jacobs JW, Bijlsma JW. et al . The effectiveness of early treatment with “second-line” antirheumatic drugs. A. randomized, controlled trial. Ann Intern Med. 1996; 124 699-707
- 12 Goekoop-Ruiterman YP, Vries-Bouwstra JK, Allaart CF. et al . Clinical and radiographic outcomes of four different treatment strategies in patients with early rheumatoid arthritis (the BeSt study): a randomized, controlled trial. Arthritis Rheum. 2005; 52 3381-3390
- 13 Grigor C, Capell H, Stirling A. et al . Effect of a treatment strategy of tight control for rheumatoid arthritis (the TICORA study): a single-blind randomised controlled trial. Lancet. 2004; 364 263-269
- 14 Salaffi F, Filippucci E, Carotti M. et al . Inter-observer agreement of standard joint counts in early rheumatoid arthritis: a comparison with grey scale ultrasonography – a preliminary study. Rheumatology (Oxford). 2008; 47 54-58
- 15 Brown AK, Conaghan PG, Karim Z. et al . An explanation for the apparent dissociation between clinical remission and continued structural deterioration in rheumatoid arthritis. Arthritis Rheum. 2008; 58 2958-2967
- 16 Karonitsch T, Aletaha D, Boers M. et al . Methods of deriving EULAR/ACR recommendations on reporting disease activity in clinical trials of patients with rheumatoid arthritis. Ann Rheum Dis. 2008; 67 1365-1373
- 17 Aletaha D, Landewe R, Karonitsch T. et al . Reporting disease activity in clinical trials of patients with rheumatoid arthritis: EULAR/ACR collaborative recommendations. Arthritis Rheum. 2008; 59 1371-1377
- 18 Goldsmith CH, Smythe HA, Helewa A. Interpretation and power of a pooled index. J Rheumatol. 1993; 20 575-578
- 19 Bombardier C, Tugwell P. A methodological framework to develop and select indices for clinical trials: statistical and judgmental approaches. J Rheumatol. 1982; 9 753-757
Korrespondenzadresse
Dr. Daniel AletahaMD, MSc
Division of Rheumatology
Medical University Vienna
Währinger Gürtel 18–20
1090 Vienna
Austria
Phone: +43/140/400 43 49
Fax: +43/140/400 43 06
Email: daniel.aletaha@meduniwien.ac.at