Scoring Model to Predict a Low Disease Activity in Elderly Rheumatoid Arthritis Patients Initially Treated with Biological Disease-modifying Antirheumatic Drugs
| Autor: | Kosuke Sakurai, Noriko Kohyama, Takahiro Okada, Yusuke Miwa, Miki Takenaka, Mari Kogo, Takashi Yamaguchi, Tatsuya Kurihara |
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| Rok vydání: | 2021 |
| Předmět: |
Male
rheumatoid arthritis scoring model medicine.medical_specialty Blood Sedimentation 030204 cardiovascular system & hematology elderly Arthritis Rheumatoid 03 medical and health sciences 0302 clinical medicine Rheumatoid Factor Internal medicine Internal Medicine medicine Humans Rheumatoid factor Aged Retrospective Studies Receiver operating characteristic medicine.diagnostic_test business.industry biological disease-modifying antirheumatic drugs Area under the curve Retrospective cohort study General Medicine Odds ratio medicine.disease Confidence interval Treatment Outcome Antirheumatic Agents Rheumatoid arthritis Erythrocyte sedimentation rate Female Original Article 030211 gastroenterology & hepatology business |
| Zdroj: | Internal Medicine |
| ISSN: | 1349-7235 0918-2918 |
| DOI: | 10.2169/internalmedicine.6251-20 |
| Popis: | Objective We aimed to develop a scoring model to predict a low disease activity (LDA) in elderly rheumatoid arthritis (RA) patients initially treated with biological disease-modifying antirheumatic drugs (bDMARDs). Methods This retrospective cohort study included 82 elderly RA patients who initially received bDMARDs. The outcome was an LDA after bDMARDs initiation. We developed a predictive formula for an LDA using a multivariate analysis, the accuracy of which was assessed by the area under the curve (AUC) of the receiver operating characteristic curves; the scoring model was developed using the formula. For each factor, approximate odds ratios were scored as an integer, divided into three groups based on the distribution of these scores. In addition, the scoring model accuracy was assessed. Results The mean age was 73.5±6.0 years old, and 86.6% were women. An LDA was achieved in 43 patients (52.4%). The predictive formula for an LDA was prepared using six factors selected for the multivariable analysis: the neutrophil-to-lymphocyte ratio (NLR), anemia, the 28-joint disease activity score with erythrocyte sedimentation rate (DAS28-ESR), serum level of matrix metalloproteinase-3 (MMP-3), diabetes mellitus (DM), and rheumatoid factor (RF). The AUC for the formula was 0.829 (95% confidence interval, 0.729-0.930). The odds ratios of the six factors were scored (DAS28-ESR and serum MMP-3=1 point, NLR, anemia, DM, and RF=2 points) and divided into three groups (≤4, 5-7, and ≥8). The high-score group (≥8) achieved a positive predictive value of 83%. Conclusion The scoring model accurately predicted an LDA in elderly RA patients initially treated with bDMARDs. |
| Databáze: | OpenAIRE |
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