リウマチ関節炎と脳卒中リスクの関連性 血清学的状態と脳卒中サブタイプ
Alicia Shin1, Seonyoung Kang2, Jin-Hyung Jung3
1University of California, Los Angeles, USA.
まとめ
病原性関節炎 (RA) の患者は,不全性脳卒中と出血性脳卒中の両方のリスクが高くなります. 血清陽性RA患者は血清陰性RA患者よりも脳卒中のリスクが高く,標的型合成疾患変異性抗レウマティック薬 (tsDMARDs) のさらなる研究が必要であることを強調しています.
科学分野:
- リウマトロジ
- 神経学
- 流行病学について
背景:
- リウマチ性関節炎 (RA) は脳卒中リスクの増加と関連しているが,血清状態と脳卒中サブタイプによる区別は不明である.
- RA患者の脳卒中リスクに対する生物学的および標的型合成抗レウマティック薬 (b/ tsDMARDs) の影響については,さらなる調査が必要である.
研究 の 目的:
- リウマチ性関節炎 (RA) と 缺血性脳卒中 (IS) と 出血性脳卒中 (HS) のリスクとの関連を調査する.
- 血清陽性RA (SPRA) と血清陰性RA (SNRA) の患者の脳卒中リスクを比較する.
- RA患者の脳卒中リスクに対するb/ tDMARDの影響を評価する.
主な方法:
- 韓国国民健康保険サービスデータベースを利用した全国的なコホート研究.
- 2010年から2017年の間に診断された45,175人のRA患者で,以前は脳卒中歴はなかった.
- 135,525匹のマッチした非RA対照群との比較
主要な成果:
- RA患者は対照群と比較して,IS (aHR1. 47) とHS (aHR1. 31) のリスクが著しく高かった.
- SPRA患者は,SNRA患者 (IS aHR 1.23,HS aHR 1. 09) よりも,IS (aHR 1.56) とHS (aHR 1.40) のリスクが高く示されました.
- 生物学的DMARDs (bDMARDs) の使用者と非使用者の間で脳卒中リスクの有意な差は認められなかったが,標的型合成DMARDs (tsDMARDs) の使用ではリスクの減少傾向が見られた (aHR 0. 81).
結論:
- RAの患者は,ISとHSの両方のリスクが大幅に上昇します.
- 血清陽性RAは,血清陰性RAと比較して,より高い脳卒中リスクと関連しています.
- RA患者における脳卒中のリスクを軽減する tsDMARDs の可能性を調査するために,さらなる研究が必要である.
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