风湿性关节炎患者持续疼痛的影响,尽管缓解状态:来自KOBIO注册表的数据
Hyoun-Ah Kim1, So Young Park2, Kichul Shin2
1Department of Rheumatology, Ajou University School of Medicine, Suwon, Korea.
Journal of rheumatic diseases
|July 21, 2023
概括
许多类风湿性关节炎患者即使在缓解期也会经历持续的疼痛. 脚部侵蚀,神经疾病和皮质类固醇使用与这种中度至重度的疼痛有关.
科学领域:
- 类风湿病学 类风湿病学
- 临床医学 临床医学
- 疼痛管理 疼痛管理
背景情况:
- 类风湿性关节炎 (RA) 是一种慢性自身免疫性疾病,其特征是关节炎症.
- 在RA的临床缓解是由低的疾病活动来定义的,但持续的疼痛仍然是许多患者的一个重要问题.
- 了解导致RA缓解疼痛的因素对于改善患者生活质量至关重要.
研究的目的:
- 为了确定在RA患者中疼痛的流行率,这些患者已经实现了临床缓解.
- 确定与缓解期的RA患者持续疼痛相关的人口和临床特征.
- 分析影响中度至重度疼痛的因素,尽管达到缓解.
主要方法:
- 分析了韩国风湿病学学院生物药物和向治疗注册表中的1891名患者的数据.
- 缓解的定义是使用28个关节的疾病活动评分 - 红细胞沉率 (ESR) <2.6.6.
- 使用视觉模拟尺度 (VAS),疼痛强度被分类为严重 (≥7),中度 (4-6.9) 或轻度 (<4).
主要成果:
- 超过一半 (52.6%) 的患者在生物或向合成DMARD治疗期间或开始时报告严重疼痛.
- 尽管随访1年后的缓解率为36.0%,但这些患者中有21.5%的患者经历了中度至严重的疼痛.
- 脚部侵蚀,神经疾病和皮质类固醇使用独立地与RA缓解中中度至重度疼痛相关;ESR和JAK抑制剂使用显示反向关联.
结论:
- 持续性疼痛是临床缓解期的RA患者的常见和重大问题.
- 诸如足部侵蚀,神经相关疾病和皮质类固醇使用等因素有助于持续的疼痛.
- 需要进一步的研究来开发有效的减轻疼痛的策略,并改善缓解的RA患者的生活质量.
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