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Plasma fibrinogen along with patient-reported outcome measures enhances management of polymyalgia rheumatica: a prospective study.
McCarthy, Eoghan M; MacMullan, Paul A; Al-Mudhaffer, Shibeb; Madigan, Anne; Donnelly, Suzanne; McCarthy, Conor J; Molloy, Eamonn S; Kenny, Dermot; McCarthy, Geraldine M.
Afiliação
  • McCarthy EM; From the Department of Rheumatology, Mater Misericordiae University Hospital, Dublin; Department of Rheumatology, St. Vincents University Hospital, Dublin; and Department of Molecular and Cellular Therapeutics, Royal College of Surgeons, Dublin, Ireland.
J Rheumatol ; 41(5): 931-7, 2014 May.
Article em En | MEDLINE | ID: mdl-24692520
ABSTRACT

OBJECTIVE:

We sought to prospectively examine the responsiveness of a number of patient-reported outcome (PRO) measures in polymyalgia rheumatica (PMR), as well as their relationship to the biomarkers erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and plasma fibrinogen.

METHODS:

Sixty patients with PMR were divided into active (n = 25) or inactive (n = 35) disease groups based on symptoms; physician assessment; and the biomarkers ESR, CRP, and plasma fibrinogen. Groups underwent assessment at baseline and 6 weeks. Disease activity measures and relevant PRO measures were recorded. Measures of responsiveness were compared for all PRO and biomarkers.

RESULTS:

Visual analog scale disease activity (VASDA) and VAS quality of life (VASQOL) are more responsive to change in disease activity than VAS pain, morning stiffness, Health Assessment Questionnaire (HAQ), and PMR-activity score (AS). Analysis of PMR-AS versus VASDA, VASQOL, and HAQ showed correlation coefficients of 0.87 (p < 0.001), 0.80 (p < 0.001), and 0.68 (p < 0.001), respectively. Receiver-operating curve (ROC) analysis revealed VASDA to be more specific than either HAQ (0.95 vs 0.85; p < 0.001) or VASQOL (0.95 vs 0.93; p < 0.001) for the detection of response to treatment in active PMR. Overall, fibrinogen showed superior correlation coefficients with the various PRO than either of the standard biomarkers ESR or CRP. In addition, standardized response means for fibrinogen, ESR, and CRP were 1.63, 1.2, and 1.05, respectively, indicating that plasma fibrinogen was the most responsive biomarker for assessment of change in disease activity.

CONCLUSION:

VASDA and VASQOL are the most responsive PRO to changes in disease activity in PMR. In addition, plasma fibrinogen demonstrated greater responsiveness to changes in disease activity and superior correlation with the various PRO measures recorded than did the standard biomarkers ESR and CRP.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Polimialgia Reumática / Índice de Gravidade de Doença / Fibrinogênio / Monitoramento de Medicamentos / Corticosteroides Tipo de estudo: Observational_studies / Prognostic_studies Limite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2014 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Polimialgia Reumática / Índice de Gravidade de Doença / Fibrinogênio / Monitoramento de Medicamentos / Corticosteroides Tipo de estudo: Observational_studies / Prognostic_studies Limite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2014 Tipo de documento: Article