Abstract：
OBJECTIVE: There is scant research about laboratory monitoring in people taking conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) for rheumatic disease. Our objective was to conduct a scoping study to assess the range of current attitudes and the variation in practice of laboratory monitoring of csDMARDs by rheumatologists and trainees.
METHODS: Australian and overseas rheumatologists or trainees were invited through newsletter, Twitter and personal e-mail, to complete an anonymous online survey between 1 February and 22 March 2021. Questions focused on laboratory tests requested by csDMARD prescribed, frequency/pattern of monitoring, influence of additional factors and combination therapy, actions in response to abnormal tests, and attitudes to monitoring frequencies. Results were presented descriptively and analysed using linear and logistic regression.
RESULTS: There were 221 valid responses. Most respondents were from Australia (n = 53, 35%) followed by the US (n = 39, 26%), with a slight preponderance of women (n = 84, 56%), ≥ 11 years in rheumatology practice (n = 83, 56%) and in mostly public practice (n = 79, 53%). Respondents had a wide variation in the frequency and scheduling of tests. In general, respondents reported increasing monitoring frequency if patients had numerous comorbidities or if both methotrexate and leflunomide were being taken concurrently. There was a wide variety of responses to abnormal monitoring results and 27 (40%) considered that in general, monitoring tests are performed too frequently.
CONCLUSIONS: The results demonstrated a wide variation in the frequency of testing, factors that should influence this, and what responses to abnormal test results are appropriate, indicates a likely lack of evidence and the need to define the risks, benefits and costs of different csDMARD monitoring regimens.
METHODS: Australian and overseas rheumatologists or trainees were invited through newsletter, Twitter and personal e-mail, to complete an anonymous online survey between 1 February and 22 March 2021. Questions focused on laboratory tests requested by csDMARD prescribed, frequency/pattern of monitoring, influence of additional factors and combination therapy, actions in response to abnormal tests, and attitudes to monitoring frequencies. Results were presented descriptively and analysed using linear and logistic regression.
RESULTS: There were 221 valid responses. Most respondents were from Australia (n = 53, 35%) followed by the US (n = 39, 26%), with a slight preponderance of women (n = 84, 56%), ≥ 11 years in rheumatology practice (n = 83, 56%) and in mostly public practice (n = 79, 53%). Respondents had a wide variation in the frequency and scheduling of tests. In general, respondents reported increasing monitoring frequency if patients had numerous comorbidities or if both methotrexate and leflunomide were being taken concurrently. There was a wide variety of responses to abnormal monitoring results and 27 (40%) considered that in general, monitoring tests are performed too frequently.
CONCLUSIONS: The results demonstrated a wide variation in the frequency of testing, factors that should influence this, and what responses to abnormal test results are appropriate, indicates a likely lack of evidence and the need to define the risks, benefits and costs of different csDMARD monitoring regimens.
摘要：
目的：对风湿性疾病患者服用常规合成抗风湿药（csDMARDs）的实验室监测研究很少。我们的目标是进行范围研究，以评估风湿病学家和受训者对csDMARDs进行实验室监测的当前态度范围和实践变化。
方法：通过时事通讯邀请澳大利亚和海外风湿病专家或学员，Twitter和个人电子邮件，在2021年2月1日至3月22日之间完成匿名在线调查。问题集中在csDMARD规定的实验室测试要求上，监测的频率/模式，其他因素和联合治疗的影响，应对异常测试的行动，以及对监控频率的态度。结果以描述性方式呈现，并使用线性和逻辑回归进行分析。
结果：有221个有效反应。大多数受访者来自澳大利亚（n=53，35%），其次是美国（n=39，26%），女性略占优势(n=84，56%)，在风湿病实践中≥11年（n=83，56％），在大多数公共实践中（n=79，53％）。受访者在测试的频率和时间安排上差异很大。总的来说,受访者报告称,如果患者有多种合并症或同时服用甲氨蝶呤和来氟米特,监测频率会增加.对异常的监测结果有各种各样的反应，27(40%)认为总的来说，监测测试执行过于频繁。
结论：结果表明测试频率差异很大，应该影响这一点的因素，以及对异常测试结果的反应是适当的，表明可能缺乏证据，需要定义风险，不同CSDMARD监测方案的收益和成本。
方法：通过时事通讯邀请澳大利亚和海外风湿病专家或学员，Twitter和个人电子邮件，在2021年2月1日至3月22日之间完成匿名在线调查。问题集中在csDMARD规定的实验室测试要求上，监测的频率/模式，其他因素和联合治疗的影响，应对异常测试的行动，以及对监控频率的态度。结果以描述性方式呈现，并使用线性和逻辑回归进行分析。
结果：有221个有效反应。大多数受访者来自澳大利亚（n=53，35%），其次是美国（n=39，26%），女性略占优势(n=84，56%)，在风湿病实践中≥11年（n=83，56％），在大多数公共实践中（n=79，53％）。受访者在测试的频率和时间安排上差异很大。总的来说,受访者报告称,如果患者有多种合并症或同时服用甲氨蝶呤和来氟米特,监测频率会增加.对异常的监测结果有各种各样的反应，27(40%)认为总的来说，监测测试执行过于频繁。
结论：结果表明测试频率差异很大，应该影响这一点的因素，以及对异常测试结果的反应是适当的，表明可能缺乏证据，需要定义风险，不同CSDMARD监测方案的收益和成本。
