IMPROVED OUTCOME IN RA BY SELECTION OF OPTIMAL SPECIFIC THERAPIES

通过选择最佳的特异性疗法改善 RA 的疗效

• 批准号: 6100637
• 负责人: FREDERICK WOLFE
• 金额: $ 21.52万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-05-01 至 2000-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6100637
• 关键词: antiarthritic agent; behavioral /social science research tag; blood chemistry; clinical research; drug adverse effect; drug screening /evaluation; functional ability; health care cost /financing; human population study; human subject; human therapy evaluation; longitudinal human study; outcomes research; pain; patient care management; prognosis; quality of life; rheumatoid arthritis; skeletal disorder chemotherapy; statistics /biometry

Therapy for rheumatoid arthritis consists of a variety of specific treatments applied sequentially, either alone or in combination. Long- term management may thus be considered to be represented by a series of "therapeutic segments." This project analyzes the effectiveness, toxicity, and costs of each segment. It develops cost-effectiveness and toxicity-effectiveness ratios for each drug, conditional upon patient characteristics and prior therapy. The project introduces the important new clinical concepts of the "therapeutic segment" and of effectiveness conditioned upon immediately preceding therapy. The current project will evaluate new drug starts in over 7000 RA patients with many studied from the first year of disease. Effectiveness will be determined by drug effects upon disability levels, pain levels, and patient global assessments, determined by adjusted differences between pre- and post-treatment values over different time periods and at the beginning and end of therapeutic segments and by comparison of observed and expected values based upon linear regression in individual patients. Toxicity will be estimated by the Toxicity Index, with improved weighting techniques to be developed in the Project. Drug costs will be calculated as costs of drugs, costs of monitoring, costs of additional patient visits, and costs of treatment and prophylaxis for toxicity. This project builds upon large, long-term, high quality data sets, and techniques for estimation of effectiveness, toxicity, and costs developed by this team, in order to provide unique and important data to guide therapeutic choices toward improved outcomes for RA patients.

类风湿关节炎的治疗包括多种特异性 单独或组合依次应用治疗。长的- 因此，可以认为术语管理由一系列代表 “治疗段”。该项目分析了有效性， 毒性和每个细分市场的成本。它发展了成本效益和 每种药物的毒性效果比，有条件 特征和先前的疗法。 该项目介绍了重要的 “治疗部分”和有效性的新临床概念 以立即治疗为条件。 当前项目将评估新药的开始，以超过7000 RA 许多患者从疾病第一年开始研究。效力 将由药物对残疾水平，疼痛水平的影响确定， 和患者全球评估，由调整差异确定 在不同时间段的治疗后值和后处理值之间 在治疗片段的开始和结尾，并比较 根据个体的线性回归观察和期望值 患者。 毒性将由毒性指数估计， 改进了项目中要开发的加权技术。药物成本 将计算为药物成本，监测成本，成本 额外的患者就诊以及治疗成本和预防成本 毒性。 该项目以大型，长期，高质量的数据集为基础，并且 估计有效性，毒性和成本的技术 由这个团队提供独特而重要的数据来指导 针对RA患者改善预后的治疗选择。