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Abstract：
To define relevant disease parameters and their respective limits indicating the initiation of TNF-alpha-blockers in individual patients. Subsequently, to analyze retrospectively patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) or ankylosing spondylitis (AS), who started TNF-alpha inhibition in 2006. Points to consider, regarded relevant for individual treatment decisions as well as their assessment methods, were ascertained by experts\' consensus applying the Delphi technique. Subsequently, these parameters\' thresholds with respect to the initiation of a TNF-alpha-blocker were identified. Thereafter, the rheumatologists representing 12 centres all over Austria agreed to retrospectively analyze their patients started on a TNF-alpha-blocker in 2006. Experts\' opinion regarding disease parameters relevant to initiate TNF-alpha-blockers in RA patients only slightly differed from those applied in clinical trials, but the parameters\' threshold values were considerably lower. For PsA patients, some differences and for AS patients, considerable differences between experts\' opinion and clinical studies appeared, which held also true for decisive parameters\' means and thresholds. Six hundred and fifty patients, started on TNF-blockers in 2006, could be analyzed retrospectively, 408 RA patients (53.3 years mean, 340 females), 93 PsA patients (48.9 years mean, 59 males) and 149 AS patients AS (42.2 years mean, 108 males), representing approximately 25% of all Austrian patients initiated on a TNF-blocker in this respective year. Far more individualized, patient-oriented treatment approaches, at least in part, are applied in daily routine compared with those derived from clinical trials or recommendations from investigative rheumatologists.
摘要：
定义相关疾病参数及其各自的限制，以指示个体患者中TNF-α受体阻滞剂的起始。随后，回顾性分析类风湿关节炎（RA）患者，银屑病关节炎（PsA）或强直性脊柱炎（AS），他在2006年开始抑制TNF-α。需要考虑的要点，被认为与个人治疗决策及其评估方法相关，由专家使用德尔菲技术达成共识。随后，确定了这些参数与TNF-α受体阻滞剂起始相关的阈值.此后,来自奥地利12个中心的风湿病学家同意对2006年开始使用TNF-α受体阻滞剂的患者进行回顾性分析.关于RA患者中与起始TNF-α受体阻滞剂相关的疾病参数的专家意见仅与临床试验中应用的略有不同。但参数阈值要低得多。对于PsA患者，一些差异，对于AS患者，专家意见和临床研究之间出现了相当大的差异，对于决定性的参数“手段”和阈值也是如此。六百五十名病人，2006年开始服用TNF阻滞剂，可以进行回顾性分析，408例RA患者（平均53.3年，340名女性），93名PsA患者（平均48.9年，59名男性）和149名AS患者（平均42.2年，108名男性），分别代表今年开始使用TNF受体阻滞剂的所有奥地利患者的约25％。更加个性化，以患者为导向的治疗方法，至少在某种程度上,与来自临床试验或研究风湿病学家的建议相比，在日常生活中应用。
