Cervical spine involvement risk factors in rheumatoid arthritis: a meta-analysis

This study aims to discuss risk factors associated with cervical spine involvement (CSI) in patients with rheumatoid arthritis (RA).

A literature search was performed in Medline, EMBASE, Web of Science and CBMdisc databases for potential studies published before October 2016. The clinical and laboratory data were extracted, and a meta-analysis was performed to evaluate the risk factors for CSI in RA patients.

Twelve studies involving a total of 2750 cases with RA and 733 CSI (26.65%) were eligible and included in this meta-analysis. The results showed that risk factors for CSI were female (odds ratio [OR] = 1.37, 95% confidence interval [CI]: 1.079-1.74), positive rheumatoid factor (RF) (OR = 1.351, 95% CI: 1.084-1.683), long-term corticosteroids treatment (OR = 2.208, 95% CI: 1.732-2.815), erosion in hands or feet (OR = 2.559, 95% CI: 1.985-3.299), age (weighted mean difference [WMD] = -2.464 years, 95% CI: -3.688 to -1.240), RA duration (WMD = 1.495 years, 95% CI: 0.870-2.121), erythrocyte sedimentation rate (ESR) level (standard mean difference [SMD] = 0.288, 95% CI: 0.161-0.41), C-reactive protein (CRP) level (SMD = 0.288, 95% CI: 0.161-0.415), Disease Activity Score of 28 joints (SMD = 0.5, 95% CI: 0.303-0.697).

The significant risk factors for CSI in RA were female gender, positive RF, long-term corticosteroids treatment, peripheral joints erosions, younger age, long RA duration, markers of higher disease activity (ESR, CRP and Disease Activity Score).