Remission/ low disease activity (LDA) are the main treatment goals in rheumatoid arthritis (RA) patients. Two tools showing the ability to predict golimumab treatment outcomes in patients with RA ...were published.
To estimate the real-world accuracy of two quantitative tools created to predict RA remission and low disease activity.
Multicenter, observational study, using data from the Rheumatic Diseases Portuguese Register (Reuma.pt), including biologic naïve RA patients who started an anti-TNF as first-line biologic and with at least 6 months of follow-up. The accuracy of two matrices tools was assessed by likelihood-ratios (LR), sensitivity (SN), specificity (SP), positive predictive value (PPV), negative predictive value (NPV) and area under the ROC curve (AUC).
674 RA patients under first-line anti-TNF (266 etanercept, 186 infliximab, 131 adalimumab, 85 golimumab, 6 certolizumab pegol) were included. The median (IQR) age was 53.4 (44.7-61.1) years and the median disease duration was 7.7 (3.7-14.6) years. The majority were female (72%). Most patients were RF and/or ACPA positive (75.5%) and had erosive disease (54.9%); 58.6% had comorbidities. At 6-months, 157 (23.3%) patients achieved remission (DAS28 ESR < 2.6) and 269 (39.9%) LDA (DAS28 ESR ≤ 3.2). Area under the curve for remission in this real-world sample was 0.756 IC 95% (0.713-0.799) and for LDA was 0.724 IC 95% (0.686 -0.763). The highest LR (8.23) for remission state was obtained at a cut-off ≥ 67%, with high specificity (SP) (99.6%) but low sensitivity (SN) (3.2%). A better balance of SN and SP (65.6% and 73.9%, respectively) was observed for a cut-off >30%, with a LR of 2.51, PPV of 43.3% and NPV of 87.6%.
In this population, the accuracy of the prediction tool was good for remission and LDA. Our results corroborate the idea that these matrix tools could be helpful to select patients for anti-TNF therapy.
Heart failure and health related quality of life Coelho, Rui; Ramos, Sónia; Prata, Joana ...
Clinical practice and epidemiology in mental health,
2005-Oct-04, 20051004, Volume:
1, Issue:
1
Journal Article
Peer reviewed
Open access
Quality of life is a major goal in the context of preventive and therapeutic cardiology. It is important, both as an outcome measure in clinical trials of congestive heart failure (CHF) and as a ...consideration in individual physicians' therapeutic decisions. In this article, quality of life concepts are reviewed, methods of measurement are explored and clinically significant changes on prognosis are discussed. There is a need for more research which is based on carefully selected measures of quality of life chosen as being of particular importance to patients and to the hypotheses being tested.
In a community sample of 102 Portuguese white women we evaluated the relationship between osteoporosis and indexes of psychopathology and well-being. Depressive symptoms were assessed by the Beck ...Depression Inventory (BDI), psychopathology by the Hopkins Symptom Checklist-90 Revised (SCL-90-R), and quality of life using the Psychological General Well-Being Index. A questionnaire comprising social, demographic, clinical, and behavioral characteristics was also used. The sample prevalence of osteoporosis was 47.1%. Women with osteoporosis presented significantly higher scores on the total BDI
16±9
vs. 13±10, p=0.045
and lower scores in the hostility
0.8±0.6
vs. 1.2±0.7, p=0.012
and phobic anxiety
1.1±0.8
vs. 1.5±0.9, p=0.041
subscales of the SCL-90-R. No differences were found regarding mean general well-being scores
62±17
vs. 64±19, p=0.665
. This study showed that women with osteoporosis have significantly higher levels of depressive symptoms and a corresponding higher prevalence of depression, independent of other factors strongly associated with osteoporosis, such as age or body mass index.
PDF
