标签: TEMPO研究; 依那西普; 放射学进展; 类风湿关节炎

TEMPO研究第一年影像学数据: 骨侵蚀修复几乎只出现在无关节肿胀或肿胀改善组

EULAR2007. Abstract No: OP0011.

D. van der Heijde 1, C. Lukas 1, S. Fatenejad 2, R. Landewe 1.

1Rheumatology, University Hospital, Maastrict, Netherlands, 2Research and Development, Wyeth, Collegeville, United States

背景:双盲试验中vdHSharp评分变化呈负数提示有效的治疗可以修复关节。在单关节水平进行研究能帮助进一步理解关节修复过程。

目的:如果真的存在关节修复(repair),判断修复是否偏好发生于无肿胀或肿胀有改善的关节。

方法:TEMPO试验第1年MTX单用组(M)、Etanercept+MTX组(M+E)患者手/腕和足部摄片后,对所有单关节的判读结 果进行评估。采用vdHSharp评分系统,对治疗和摄片顺序均不知晓的两位读片师各自对所有平片重复判读两次。计算单关节骨侵蚀评分变化,并与单关节肿 胀评分变化相关联。单关节修复的评判:四次判读中至少有一次为负数变化而其它判读变化结果均为零(即无进展)。每关节骨侵蚀变化均数,是通过减去基线均数 而得。

结果:共计11159个单关节中,判读为有修复的为557个,其中553个同时有肿胀评分。下表显示各种肿胀评分变化在"修复关节"组、 "无修复关节"组中的分布。修复组无肿胀关节共计234个,其中12个有残余肿胀,222个无肿胀。肿胀改善即评分变化为负数的关节共计318个,仅36 个有残余肿胀。与无修复相比,修复与肿胀改善显著相关(p<0.0001)。

持续肿胀组骨侵蚀变化均数(95%可信区间)如下,基线无破坏组为0.03 [0.01,0.04],基线有破坏组为0.06 [–0.02,0.14]),而无肿胀或肿胀改善组患者的更低,基线无破坏组为0.01[0.00,0.01],基线有破坏组为-0.09[-0.11,-0.06]。基线有骨侵蚀时,骨侵蚀变化均数只在无肿胀或肿胀改善亚组呈显著负数变化。

结论:骨侵蚀修复几乎只出现在肿胀改善或肿胀消失组。持续肿胀关节中的骨破坏仍在进展,尤其是基线已有骨损害者。这项观察研究进一步确证了骨侵蚀负数变化是骨修复的反映。

表.  治疗1年后修复组和无修复组的肿胀变化关节数和百分比

肿胀评分变化

-3

-2

-1

0

1

2

Total

修复组

14

95

209

234

1

0

553

(2.5%)

(17.2%)

(37.8%)

(42.3%)

(0.2%)

(0%)

(100%)

无修复组

157

943

3124

6135

129

9

10497

(1.5%)

(9.0%)

(29.8)

(58.4)

(1.2%)

(0.1%)

(100%)

请点击链接查看英文原文或参考以下文字。

[2007] [OP0011] REPAIR OF EROSIONS OCCURS ALMOST EXCLUSIVELY IN DAMAGED JOINTS WITHOUT SWELLING: POST HOC ANALYSIS OF RADIOGRAPHIC DATA FROM YEAR 1 OF THE TEMPO STUDY

D. van der Heijde 1, C. Lukas 1, S. Fatenejad 2, R. Landewe 1

1Rheumatology, University Hospital, Maastrict, Netherlands, 2Research and Development, Wyeth, Collegeville, United States

Background: Negative van der Heijde-Sharp (SvdH) change scores obtained under blinded time-sequence conditions suggest that effective therapies may result in joint repair. Investigation at the single-joint level could provide further understanding of the repair process.

Objectives: To determine whether repair – if it truly exists – preferentially occurs in joints with no swelling or improvement in swelling.

Methods: Single-joint readings of radiographic images of the hands/wrists and feet from patients in year 1 of the TEMPO trial (the methotrexate-only group [M] and the methotrexate+etanercept group [M+E]) were evaluated. Using the SvdH scoring, 2 readers blinded to treatment and true-time sequence independently assessed each of the radiographs twice. Single-joint change scores in erosions were calculated and coupled with change in single-joint swelling scores. Repair in a joint was considered to have occurred if there was a negative erosion change score in at least 1 of the 4 potential readings with the remaining readings showing zero, ie, no progression. Mean erosion change scores per joint were calculated by taking the mean score from the first reading by each reader.

Results: Of the 11,159 single joints, 557 showed repair. For 553 of these, swelling scores were also available. The table shows the distribution of change in swelling in joints showing "repair" versus "no repair". Of the 234 joints without change in swelling in the repair group, 12 had residual swelling and 222 had no swelling. Of the 318 joints with improvement in swelling (ie negative change), only 36 had residual swelling. Repair was significantly more associated with improvement in swelling than no repair (p<0.0001).

Mean change in erosion scores (95% confidence interval [CI]) were lower in patients with no swelling or improvement in swelling (group without baseline damage 0.01 [0.00, 0.01]; group with baseline damage –0.09 [–0.11; -0.06]) compared with patients with persistent swelling (group without baseline damage 0.03 [0.01, 0.04]; group with baseline damage 0.06 [–0.02, 0.14]). The mean change in erosion score was statistically significantly negative only in the subgroup of joints with absent or improving swelling, while erosions were present at baseline.

Conclusion: Repair of erosions occurs almost exclusively in damaged joints that show either improvement of swelling, or that have no swelling at all. Progression occurs in joints with persistent swelling, preferably if there is already damage present. This observation adds to the validity that negative joint scores are a reflection of repair.

Number and percentage of joints with repair or no-repair vs. 1-year change in swelling

 

-3

-2

-1

0

1

2

Total

Repair

14

95

209

234

1

0

553

(2.5%)

(17.2%)

(37.8%)

(42.3%)

(0.2%)

(0%)

(100%)

No Repair

157

943

3124

6135

129

9

10497

(1.5%)

(9.0%)

(29.8)

(58.4)

(1.2%)

(0.1%)

(100%)

Citation: Ann Rheum Dis 2007;66(Suppl II):54

TEMPO研究第一年影像学数据: 骨侵蚀修复几乎只出现在无关节肿胀或肿胀改善组的更多相关文章

  1. ComplexBrowser: a tool for identification and quantification of protein complexes in large-scale proteomics datasets(大规模蛋白组学数据集中鉴定和定量蛋白复合物)

    文献名:ComplexBrowser: a tool for identification and quantification of protein complexes in large-scale ...

  2. Saiku Table展示数据合并bug修复(二十五)

    Saiku Table展示数据合并bug修复 Saiku以table的形式展示数据,如果点击了 非空的字段 按钮,则会自动进行数据合并,为空的数据行以及数据列都会自动隐藏掉. 首先我们应该定位问题: ...

  3. 【百度地图API】如何利用自己的数据制作社交地图?只显示可视区域内的标注

    原文:[百度地图API]如何利用自己的数据制作社交地图?只显示可视区域内的标注 摘要:如果你自己的数据已经超过1万个,如何进行合理的显示?除了聚合marker外,还有一个办法.那就是,只显示可视区域内 ...

  4. 在使用Ajax请求返回json数据的时候IE浏览器弹出下载保存对话框的解决方法

    在使用Ajax请求返回json数据的时候IE浏览器弹出下载保存对话框的解决方法 最近在做一个小东西,使用kindeditor上传图片的时候,自己写了一个上传的方法,按照协议规则通过ajax返回json ...

  5. 第一章:大数据 の Linux 基础 [更新中]

    本课主题 Linux 休系结构图 Linux 系统启动的顺序 Linux 查看内存和 CPU 指令 环境变量加载顺序 Linux 内存结构 Linux 休系结构图 Linux 大致分为三个层次,第一层 ...

  6. linq中分组查询而且获取每个分组中的第一条记录,数据用于分页绑定

    LINQ分组取出第一条数据 Person1: Id=1, Name="Test1" Person2: Id=1, Name="Test1" Person3: I ...

  7. Nature Methods | 新软件SAVER-X可对单细胞转录组学数据进行有效降噪

                                                                          图片来源(Nature Methods)   摘要 单细胞转 ...

  8. 第一周<导学>

    导学 欧氏距离 平方 曼哈顿距离 一次方 马氏距离 协方差(先标准化再计算距离)\(d(x_{i},x_{j})=\sqrt{(x_{i}-x_{j})^{T}s^{-1}(x_{i}-x{j})}\ ...

  9. Androidclient和server第一种方法端数据交换

    网上有一个非常不同的情况来证明Android客户端和server如何结束的数据,但这些实施例大多相互作用更复杂,对于那些谁刚开始学习它是有害的,现在介绍一些简单的代码.逻辑清晰的互动样本,首先介绍本博 ...

  10. MySQL入门第一天——概述、数据表与约束操作

    一.概述 1.安装 初学MySQL,我们下载msi的安装版:http://dev.mysql.com/downloads/file.php?id=457403 安装的过程文字简述可以参考之前随笔:ht ...

随机推荐

  1. js-day02-综合案例ATM存款书写

     <script>                 // 1. 不断的弹出对话框         // 3. 金额的变量         let money = 100         w ...

  2. 记一次 .NET 某工控软件 内存泄露分析

    一:背景 1.讲故事 上个月 .NET调试训练营 里的一位老朋友给我发了一个 8G 的dump文件,说他的程序内存泄露了,一时也没找出来是哪里的问题,让我帮忙看下到底是怎么回事,毕竟有了一些调试功底也 ...

  3. 学习Django框架之前所需要了解的知识点

    目录 一: Web应用 1.Web应用程序什么? 2.软件开发架构 3.Web应用程序的优点 4.Web应用程序的缺点 5.B/S架构优点 6.Web框架本质 二:MVC和MTV模式 1.MVC设计模 ...

  4. Django查看内部sql语句的方式

    一:查看内部sql语句的方式 方式1(queryset对象才能够点击query查看内部的sql语句) res = models.User.objects.values_list('name', 'ag ...

  5. 解决.net Core中WebApi自动Model验证导致数据格式不能统一

    简言: 最近做项目用WebAPI Core时,想把返回数据的格式,统一弄成:{"errorMsg":"xxx","Data":"x ...

  6. 【深入浅出Spring原理及实战】「源码原理实战」从底层角度去分析研究PropertySourcesPlaceholderConfigurer的原理及实战注入机制

    Spring提供配置解析功能 主要有一下xml文件占位符解析和Java的属性@Value的占位符解析配置这两种场景进行分析和实现解析,如下面两种案例. xml文件的占位符解析配置 <bean i ...

  7. week_9(异常检测)

    Andrew Ng 机器学习笔记 ---By Orangestar Week_9 This week, we will be covering anomaly detection which is w ...

  8. Less-1(GET字符型)

    union联合注入(方法一) 进入靶场 按照要求提交一个id:http://192.168.121.131/sqli/Less-1/?id=1 数据库执行语句:select * from news w ...

  9. 一文详解RocketMQ的存储模型

    摘要:RocketMQ 优异的性能表现,必然绕不开其优秀的存储模型. 本文分享自华为云社区<终于弄明白了 RocketMQ 的存储模型>,作者:勇哥java实战分享. RocketMQ 优 ...

  10. 题解P3847 [TJOI2007]调整队形

    简要题意 给出一个长度为 \(n\) 的序列 \(A\),你需要执行下面的操作,将这个序列变成回文序列: 在序列左右侧或中间插入一个元素,元素数值任意. 删除一个元素. 更改一个元素的值. \(1 \ ...