UTICAJ TERAPIJSKIH MODALITETA NA FUNKCIONALNU SPOSOBNOST BOLESNIKA SA REUMATOIDNIM ARTRITISOM
Sažetak
Reumatoidni artritis (RA) je hronična, sistemska, inflamatorna bolest. Progresivnost bolesti i oštećenje zglobova izazvano RA može značajno uticati na sposobnost funkcionisanja. Zlatni standard za procenu funkcionalnog statusa u RA je HAQ upitnik.
Cilj rada bio je da se proceni uticaj sociodemografskih karakteristika, laboratorijskih parametara od interesa i terapijskih modaliteta na funkcionalnu sposobnost bolesnika sa RA.
Retrospektivna studija preseka uključivala je 109 bolesnika, 29 muškaraca i 83 žene, sa dijagnozom RA. Prikupljeni su podaci o demografskim i kliničkim karakteristikama bole-snika, laboratorijskim nalazima i primenjenim terapijskim modalitetima. Za statističku analizu korišćeni su Microsoft Office Excel i PASW. Nivo greške procene manji od 5% (0,05) korišćen je kao prag statističke značajnosti.
Rezultati studije ukazuju da više od trećine učesnika ima HAQ-DI indeks veći od 1, što ukazuje na značajno smanjenje funkcionalne sposobnosti. Najveći broj ispitanika sa visokim HAQ-DI indeksom (41,2%) zabeležen je u grupi ispitanika koji su koristili glukokortikoide u kombinaciji sa nekoliko sintetičkih lekova koji modifikuju bolest (GK + multiDMARD). Vrednosti HAQ-DI indeksa statistički se značajno razlikuju u odnosu na primenjene terapijske modalitete (p = 0,004). HAQ-DI indeks značajno je korelirao sa vrednostima brzine sedimentacije (p < 0,05), CRP (p < 0,01) i anti-CCP (p < 0,05). PLUM regresiona analiza pokazala je da je funkcionalna sposobnost oštećena u grupama ispitanika bez komorbiditeta i sa manjim brojem komorbiditeta. Pored toga, rezultati regresione analize ukazuju na to da terapijski modaliteti GK + metotreksat (p = 0,023) i GK + multiDMARD (p = 0,002) mogu značajno doprineti boljoj funkcionalnoj sposobnosti bolesnika sa RA.
Metotreksat, sam ili u kombinaciji sa drugim lekovima, može značajno doprineti boljoj funkcionalnoj sposobnosti i efikasan je u lečenju većine bolesnika sa RA.
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