当前位置:寻医问药专家网 > 张莉芸专家个人网站 > 文章列表 > 医学科普 > 文章详情

医学博文57-TICOPA议案研究(银屑病关节炎``````

标签:银屑病 医学科普 | 作者:张莉芸 | 发表时间:2014-02-22 14:14:46

TICOPA议案研究(银屑病关节炎的规范化治疗):通过一组随机对照试验比较强化治疗与标准治疗对早期银屑病关节炎患者的疗效

Abstract

Background: Psoriatic Arthritis(PsA) is estimated to occur in 10%-15%of people with psoriasis and accounts for 13%of people attending early arthritis clinics.With an increasing awareness of the poor outcomes associated with PsA and the availability of new effective ,but costly ,treatments,there is an urgent need to research the optimal treatment for patients with PsA .The aim of the TICOPA study is to establish whether,in treatment naive early PsA patients,tight control intensive management with protocol driven therapies and pre-defined -ive targets for treatment can improve clinical outcome compared to standard care alone.

Methods:TICOPA is a UK multicentre ,open-label,randomised controlled ,parallel group trial of 206 patients with early PsA .Patients will be randomised on a 1:1basis to receive either standard care (12 weekly review)or intensive management (4weekly review)for a period of 48 weeks.Patients assigned to the intensive management group will follow a strict treatment protocol whereby dose continuation/escalation is determined through the -ive assessment of the minimal disease acitivity(MDA)criteria.Patients assigned to the standard care group will have treatment prescribed as felt appropriate by the treating clinician,with no set protocol .The primary -ive of the trial is to compare intensive management with standard care in terms of the proportion of patients achieving an ACR20 response at 48 weeks post-randomisation,in order to determine whether intensive management has superior clinical efficacy.Key secondary outcomes include ACR50 and 70 ,PASI75 and X-ray Vander Heijde score at 48 weeks post-randomisation along with cost-effectiveness at 12,24 and 28 weeks.Discussion:The TICOPA trial will provide direct evidence as to whether the use of early and intensive treatment in PsA in routine clinical care leads to an improvement in patients disease activity and a reduction in radiological joint damage .

Keywords:psoriatic arthritis ,early psoriatic arthritis ,tight management ,tight control ,intensive management,standard care.

摘要

背景:银屑病患者中约10%~15%发展为银屑病关节炎(PsA)。其中,早期接受关节炎治疗的PsA患者仅占13%,加之目前治疗效果不佳且费用昂贵,迫切需要寻找新的治疗方法。目的:通过强化治疗及标准治疗的随机对照研究为早期的PsA患者制定一个有效改善病情的治疗方法和目标。方法:该试验在英国进行,是一个多中心、开放性、随机对照研究。研究对象:早期PsA患者206人。按1:1的比例,患者随机分为两组,分别接受标准治疗(每12周随访一次)或强化治疗(每4周随访一次)共48周。强化治疗组将遵循严格的治疗方案,剂量维持或增加取决于客观评估疾病活动(MDA)标准。标准治疗组的治疗方案由临床医生根据病情决定。随访48周, 并对所有患者进行ACR20评估,比较两组治疗效果,探查强化治疗是否有更好的临床疗效。另外,在随访12、24和28周时,对患者进行ACR50和70,PASI75和X射线Vander Heijde评分,并比较两组患者的治疗成本及效果。讨论:强化治疗能否控制患者疾病活动及减少关节损伤,TICOPA议案的临床研究将为早期PsA患者的治疗提供直接依据。

引自:The TICOPA protocol(Tight Control of Psoriatic Arthritis):a randomised controlled trial to compare intensive management versus standard care in early psoriatic arthritis Coates et al. BMC Musculoskeletal Disorders 2013,14:101


此文章内容仅代表医生观点,仅供参考。涉及用药、治疗等问题请到当地医院就诊,谨遵医嘱!

阅读(3034)| (0) | (0) 我要为张莉芸投票 >
更多

免费咨询在线专家

张莉芸

主任医师 教授

山西大医院

风湿免疫科

咨询专家 已回复咨询数:327
预约门诊 已成功预约数:85
给他投票 已获得投票数:160

同专业最新在线专家

请务必在就医后进行投票,以保证结果的公平、公正。

温馨提示