J Rheumatol:脊柱关节炎中抗肿瘤坏死因子使用建议的依从性

2017-07-03 xiangting MedSci原创

抗TNF建议的依从性对结果的影响,对所使用的依从性定义很敏感。

这项研究旨在评估一个对中轴型脊柱关节炎(axSpA)抗肿瘤坏死因子(抗TNF)使用建议依从性进行定义的分类系统,并研究依从性对DESIR队列结局的影响。

使用依从性的替代定义,患者被分为坚持"及时"抗TNF使用者,非坚持"延迟"抗TNF使用者,依从的非使用者("无抗TNF需要"),不依从的非使用者("未满足抗TNF需求")。使用拟合多变量模型来探讨在指数日期后1年内依从性对质量调整寿命年(QALY)、总成本和非生物成本的影响。使用假设对数链接的γ分布的广义线性回归模型计算QALY结果的成本结果和线性回归模型。

使用依从性的定义,延迟抗TNF使用者与及时抗TNF使用者总成本(RR 0.86,95%CI 0.54-1.36,p = 0.516)或非生物成本(RR 0.72, 95%CI 0.44-1.18,p = 0.187)没有显著差异。然而,在敏感性分析中,延迟抗TNF使用者与及时抗TNF使用者相比,非生物成本显著增加(RR 1.58,95%CI 1.06-2.36,p = 0.026)。在主要分析中,及时抗TNF使用者与延迟抗TNF使用者之间,或及时使用者与未满足抗TNF需求的患者之间的QALY无显著差异。在敏感性分析中,与及时使用者相比,未满足抗TNF需求的患者QALY明显更低(-0.04,95%CI -0.07--0.01,p = 0.016)。

抗TNF建议的依从性对结果的影响,对所使用的依从性定义很敏感,这强调了需要验证评价依从性的方法。

原始出处:

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    2017-07-05 lmm397
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    2017-07-05 fyxzlh
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    2017-07-05 millore
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