Improving of treatment efficacy for target therapy-taking rheumatoid arthritis patients. Conclusions of Moscow uniform registry of arthritis (MERA)
DOI: https://dx.doi.org/10.18565/therapy.2018.5.96-103
E.V. Zhilyaev, G.V. Lukina, E.N. Koltzova, E.I. Shmidt
1 The Department of rheumatology of Federal State Budgetary Educational Institution of Further Professional Education « Russian Medical Academy of Continuing Professional Education» of the Ministry of Healthcare of Russia, Moscow;
2 Moscow State Center of Rheumatology of State Budgetary Healthcare Institution «Moscow Clinical Scientific Center» of Moscow Health Department, Moscow, Russia;
3 Scientific research institute of health and medical management organization of Moscow Health Department, Moscow, Russia;
4 N.I. Pirogov city clinical hospital, Moscow, Russia;
5 ZAO «Urotropican medical center», Moscow, Russia;
6 V.A. Nasonova FSBSI scientific research institute of theumatology, Moscow, Russia
The data of the Moscow uniform register of arthrites (MERA) are analyzed. The analysis included patients (n = 554) with rheumatoid arthritis who received genetically engineered biological medicaments or tofacitinib at least for 6 months. During their checking visits, the information concerning the history of life, disease, therapy, and examination data was collected. The effectiveness of treatment was estimated by the achieved value of DAS-28. Under the conditions of a multifactor model, it was performed the search of significant independent predictors of the achieved activity (estimated by DAS28-ESR). It was found, that female sex, pain in the spine during the disease, age were associated with higher values of the studied activity index. A greater number of patient visits in the register and longer targeted therapy were associated with better treatment outcomes. According to the obtained results, the level of the achieved activity of the disease is significantly associated with used targeted drug (p = 0.03). However, there were no statistically significant differences between the different targeted drugs. There was no correlation between the achieved activity of the disease and the basic therapy that was used, and the use of glucocorticoids. Tactical approaches to treatment aimed at increasing its effectiveness are discussed in current article on the ground of abovementioned analysis of the MERA register data.
Keywords: rheumatic arthritis, target therapy, Moscow uniform register of arthrites (MERA)
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About the Autors
Evgeny V. Zhilyaev, MD, professor of the Department of rheumatology of Federal State Budgetary Educational Institution of Further Professional Education «Russian Medical Academy of Continuing Professional Education» of the Ministry of Healthcare of Russia, head physician of ZAO «Urotropican medical center»; Tеl.: +7(499)252-21-04; e-mail: zhilyayevev@mail.ru.
Galina V. Lukina, MD, professor of V.A. Nasonova FSBSI scientific research institute of rheumatllogy, chief of Moscow municipal center of rheumatology of State Budgetary Healthcare Institution « Moscow clinical scientific center» of Moscow Health Department.
EkaterinaN. Koltzova, head of the organization and methodology Department of rheumatology of Scientific research institute of health and medical management organization of Moscow Health Department.
Evgenia I. Shmidt, PhD, head of rheumatology Department of N.I. Pirogov city clinical hospital № 1.
Русский
