Valor pronóstico del índice de Sharp en la respuesta clínica y de laboratorio a un pulso intravenoso de metilprednisolona en pacientes con artritis reumatoídea
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 Sharps modified radiographic joint damage index for the assessment of clinical and labor...
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Sociedad Médica de Santiago
2000
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oai:scielo:S0034-988720000003000082000-06-20Valor pronóstico del índice de Sharp en la respuesta clínica y de laboratorio a un pulso intravenoso de metilprednisolona en pacientes con artritis reumatoídeaCuchacovich T,MiguelGatica R,HéctorMuñoz Ch,SaraGonzález Z,Paulina Arthritis rheumatoid Methylprednisolone Rheumatic diseases 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 Sharps modified radiographic joint damage index for the assessment of clinical and laboratory response to a methylprednisolone i.v. pulse. Patients and Methods: 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% 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 "d 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 patientsinfo:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.128 n.3 20002000-03-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872000000300008es10.4067/S0034-98872000000300008 |
| institution |
Scielo Chile |
| collection |
Scielo Chile |
| language |
Spanish / Castilian |
| topic |
Arthritis rheumatoid Methylprednisolone Rheumatic diseases |
| spellingShingle |
Arthritis rheumatoid Methylprednisolone Rheumatic diseases Cuchacovich T,Miguel Gatica R,Héctor Muñoz Ch,Sara González Z,Paulina Valor pronóstico del índice de Sharp en la respuesta clínica y de laboratorio a un pulso intravenoso de metilprednisolona en pacientes con artritis reumatoídea |
| description |
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 Sharps modified radiographic joint damage index for the assessment of clinical and laboratory response to a methylprednisolone i.v. pulse. Patients and Methods: 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% 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 "d 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 |
| author |
Cuchacovich T,Miguel Gatica R,Héctor Muñoz Ch,Sara González Z,Paulina |
| author_facet |
Cuchacovich T,Miguel Gatica R,Héctor Muñoz Ch,Sara González Z,Paulina |
| author_sort |
Cuchacovich T,Miguel |
| title |
Valor pronóstico del índice de Sharp en la respuesta clínica y de laboratorio a un pulso intravenoso de metilprednisolona en pacientes con artritis reumatoídea |
| title_short |
Valor pronóstico del índice de Sharp en la respuesta clínica y de laboratorio a un pulso intravenoso de metilprednisolona en pacientes con artritis reumatoídea |
| title_full |
Valor pronóstico del índice de Sharp en la respuesta clínica y de laboratorio a un pulso intravenoso de metilprednisolona en pacientes con artritis reumatoídea |
| title_fullStr |
Valor pronóstico del índice de Sharp en la respuesta clínica y de laboratorio a un pulso intravenoso de metilprednisolona en pacientes con artritis reumatoídea |
| title_full_unstemmed |
Valor pronóstico del índice de Sharp en la respuesta clínica y de laboratorio a un pulso intravenoso de metilprednisolona en pacientes con artritis reumatoídea |
| title_sort |
valor pronóstico del índice de sharp en la respuesta clínica y de laboratorio a un pulso intravenoso de metilprednisolona en pacientes con artritis reumatoídea |
| publisher |
Sociedad Médica de Santiago |
| publishDate |
2000 |
| url |
http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872000000300008 |
| work_keys_str_mv |
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