Zeitschrift für Rheumatologie

, Volume 65, Issue 2, pp 124–130 | Cite as

Aktivitätsscore-basierte Therapieadaptation bei chronischer Polyarthritis

  • K. P. Machold
  • V. P. K. Nell
  • D. Aletaha
  • J. S. Smolen
  • T. A. Stamm
Leitthema

Zusammenfassung

Die in den letzten Jahren entwickelten validierten Aktivitätsscores für die chronische Polyarthritis erlauben eine longitudinale Dokumentation der Effektivität der angewendeten Therapiestrategien. Durch Anwendung der Aktivitätsscores in der täglichen Routine und bei jeder Visite könnte unter vergleichsweise geringem Aufwand die Behandlung der Patienten mit chronischer Polyarthritis deutlich verbessert werden. In diesem Überblick wird die Evidenz für einen Nutzen der Anwendung dieser Scores in der klinischen Routine dargestellt.

Schlüsselwörter

Chronische Polyarthritis Krankheitsaktivitätsmessung Outcome Dokumentation Therapiekontrolle 

Activity-score based therapy in rheumatoid arthritis

Abstract

Disease activity scores for rheumatoid arthritis have been developed and validated in recent years. They allow the longitudinal documentation of the effectiveness of treatment. Application of these scores in routine daily practice could significantly improve the effectiveness of therapy with relatively little effort. This review presents evidence for the benefits of the application disease activity scores in clinical routine.

Keywords

Rheumatoid arthritis Disease activity measurement Outcome Documentation Therapy control 

Notes

Interessenkonflikt:

Es besteht kein Interessenkonflikt. Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen. Die Präsentation des Themas ist unabhängig und die Darstellung der Inhalte produktneutral.

Literatur

  1. 1.
    Aletaha D, Nell VP, Stamm T et al. (2005 a) Acute phase reactants add little to composite disease activity indices for rheumatoid arthritis: validation of a clinical activity score. Arthritis Res Ther 7:R796–R806CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Aletaha D, Ward MM, Machold KP et al. (2005 b) Remission and active disease in rheumatoid arthritis — Defining criteria for disease activity states. Arthritis Rheum 52:2625–2636CrossRefPubMedGoogle Scholar
  3. 3.
    Boers M, Verhoeven AC, Markusse HM et al. (1997) Randomised comparison of combined step-down prednisolone, methotrexate and sulphasalazine with sulphasalazine alone in early rheumatoid arthritis. Lancet 350:309–318CrossRefPubMedGoogle Scholar
  4. 4.
    Fransen J, Langenegger T, Michel BA, Stucki G (2000) Feasibility and validity of the RADAI, a self-administered rheumatoid arthritis disease activity index. Rheumatology (Oxford) 39:321–327Google Scholar
  5. 5.
    Fransen J, Stucki G, Twisk J et al. (2003) Effectiveness of a measurement feedback system on outcome in rheumatoid arthritis: a controlled clinical trial. Ann Rheum Dis 62:624–629CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Fransen J, Moens HB, Speyer I, van Riel PLCM (2005) Effectiveness of systematic monitoring of rheumatoid arthritis disease activity in daily practice: a multicentre, cluster randomised controlled trial. Ann Rheum Dis 64:1294–1298CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Goekoop-Ruiterman YPM, Vries-Bouwstra JK, Allaart CF et al. (2005) Clinical and radiographic outcomes of four different treatment strategies in patients with early rheumatoid arthritis (the BeSt study) — A randomized, controlled trial. Arthritis Rheum 52:3381–3390CrossRefPubMedGoogle Scholar
  8. 8.
    Grigor C, Capell H, Stirling A et al. (2004) Effect of a treatment strategy of tight control for rheumatoid arthritis (the TICORA study): a single-blind randomised controlled trial. Lancet 364:263–269CrossRefPubMedGoogle Scholar
  9. 9.
    Maini RN, Breedveld FC, Kalden JR et al. (1998) Therapeutic efficacy of multiple intravenous infusions of anti-tumor necrosis factor alpha monoclonal antibody combined with low-dose weekly methotrexate in rheumatoid arthritis. Arthritis Rheum 41:1552–1563CrossRefPubMedGoogle Scholar
  10. 10.
    Mottonen T, Hannonen P, Leirisalo-Repo M et al. (1999) Comparison of combination therapy with single-drug therapy in early rheumatoid arthritis: a randomised trial. FIN-RACo trial group. Lancet 353:1568–1573CrossRefPubMedGoogle Scholar
  11. 11.
    Pincus T, Segurado OG (2006) Most visits of most patients with rheumatoid arthritis to most rheumatologists do not include a formal quantiatative joint count. Ann Rheum Dis (epub ahead of print)Google Scholar
  12. 12.
    Rau R, Wassenberg S, Herborn G et al. (1998) A new method of scoring radiographic change in rheumatoid arthritis. J Rheumatol 25:2094–2107PubMedGoogle Scholar
  13. 13.
    Smolen JS, Kalden JR, Scott DL et al., The European Leflunomide Study Group (1999) Efficacy and safety of leflunomide compared with placebo and sulphasalazine in active rheumatoid arthritis: a double-blind, randomized, multicentre trial. Lancet 353:259–265CrossRefPubMedGoogle Scholar
  14. 14.
    Smolen JS, Aletaha D, Keystone E (2005) Superior efficacy of combination therapy for rheumatoid arthritis. Fact or fiction? Arthritis Rheum 52:2975–2983CrossRefPubMedGoogle Scholar
  15. 15.
    Strand V, Cohen S, Schiff M et al. (1999) Treatment of active rheumatoid arthritis with leflunomide compared with placebo and methotrexate. Arch Intern Med 159:2542–2550CrossRefPubMedGoogle Scholar
  16. 16.
    Uitz E, Fransen J, Langenegger T, Stucki G (2000) Clinical quality management in rheumatoid arthritis: putting theory into practice. Swiss Clinical Quality Management in Rheumatoid Arthritis. Rheumatology (Oxford) 39:542–549Google Scholar
  17. 17.
    Van der Heijde D (2000) How to read radiographs according to the Sharp/van der Heijde method. J Rheumatol 27:261–263Google Scholar
  18. 18.
    Van der Heijde DM, van’t Hof M, van Riel PL, van de Putte LB (1993) Development of a disease activity score based on judgment in clinical practice by rheumatologists. J Rheumatol 20:579–581Google Scholar
  19. 19.
    Van Gestel AM, Anderson JJ, van Riel PL et al. (1999) ACR and EULAR improvement criteria have comparable validity in rheumatoid arthritis trials. American College of Rheumatology European League of Associations for Rheumatology. J Rheumatol 26:705–711Google Scholar
  20. 20.
    Weinblatt ME, Coblyn JS, Fox DA et al. (1985) Efficacy of low-dose methotrexate in rheumatoid arthritis. N Engl J Med 312:818–822CrossRefPubMedGoogle Scholar
  21. 21.
    Weinblatt ME, Trentham DE, Fraser PA et al. (1988) Long-term prospective trial of low-dose methotrexate in rheumatoid arthritis. Arthritis Rheum 31:167–175CrossRefPubMedGoogle Scholar
  22. 22.
    Weinblatt ME, Kremer JM, Bankhurst AD et al. (1999) A trial of etanercept, a recombinant tumor necrosis factor receptor:Fc fusion protein, in patients with rheumatoid arthritis receiving methotrexate. N Engl J Med 340:253–259CrossRefPubMedGoogle Scholar
  23. 23.
    Weinblatt ME, Keystone EC, Furst DE et al. (2003) Adalimumab, a fully human anti-tumor necrosis factor a monoclonal antibody, for the treatment of rheumatoid arthritis in patients taking concomitant methotrexate — The ARMADA trial. Arthritis Rheum 48:35–45CrossRefPubMedGoogle Scholar

Copyright information

© Springer Medizin Verlag 2006

Authors and Affiliations

  • K. P. Machold
    • 1
    • 2
  • V. P. K. Nell
    • 1
  • D. Aletaha
    • 1
  • J. S. Smolen
    • 1
  • T. A. Stamm
    • 1
  1. 1.Klinische Abt. für RheumatologieUniversitätsklinik für Innere Medizin IIIWien
  2. 2.Klinische Abt. für RheumatologieUniversitätsklinik für Innere Medizin IIIWien

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