Valor pronóstico del índice de Sharp en la respuesta clínica y de laboratorio a un pulso intravenoso de metilprednisolona en pacientes con artritis reumatoídea / Prognostic value of Sharp index in the clinical and laboratory response to an iv methylprednisolone pulse in patients with rheumatoid arthritis
Rev. méd. Chile
; 128(3): 301-8, mar. 2000. tab, graf
Article
in Es
| LILACS
| ID: lil-260189
Responsible library:
CL1.1
RESUMO
Background:
No reliable variables to predict clinical or laboratory response to treatment in patients with rheumatoid arthritis were available until recently.Aim:
To asses the potential predictive value of the Sharp's modified radiographic joint damage index for the assessment of clinical and laboratory response to a methylprednisolone i.v. pulse. Patients andMethods:
Twenty-two patients suffering from rheumatoid arthritis received a single i.v. pulse of 1 g of methylprednisolone. Hand X-rays were taken at baseline and blindly scored by two trained radiologists. Clinical and laboratory variables were assessed at baseline and at weekly intervals up to 30 days plus a 60 days final evaluation. Improvement was defined as a 50 percent amelioration in 4 variables.Results:
Assessment of radiographic scores had a high correlation between and within observers (intraclass correlation= 0.998). Sharp score did not reach statistical significance as global predictor for the inflammatory variable response to methylprednisolone. However, when the number of swollen joints was taken into account, patients with a low erosive score (Sharp ² 50) had a more prolonged clinical response, than patients with higher erosive score (Sharp >50) (Fisher test p= 0.023). It is of clinical importance to point out that among patients with high Sharp score there were also responders who reached a high level of improvement. A statistically significant correlation between the basal PCR serum titers and the radiographic score (p< 0.02) was observed.Conclusions:
The number of swollen joints and other variables that consider joint structural changes should be considered for the assessment of rheumatoid arthritis patients
Full text:
1
Index:
LILACS
Main subject:
Arthritis, Rheumatoid
/
Methylprednisolone
Type of study:
Prognostic_studies
Limits:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
Language:
Es
Journal:
Rev. méd. Chile
Journal subject:
MEDICINA
Year:
2000
Type:
Article