一个策略,以解开治疗不耐治疗的错误诊断的轴性脊髓关节炎
Dennis McGonagle1, Roberta Ramonda2, Laura Scagnellato2
1University of Leeds, Leeds Institute of Rheumatic and Musculosckeletal Medicine, Leeds, United Kingdom.
Autoimmunity reviews
|August 5, 2023
概括
轴性脊柱关节炎 (axSpA) 包括放射性和非放射性形式. 误诊和治疗失败是常见的挑战,需要更清晰地定义耐火性axSpA.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 放射学 放射学是一门学科.
背景情况:
- 轴性脊柱关节炎 (axSpA) 包括放射性 (r-axSpA) 和非放射性 (nr-axSpA) 形式.
- 核磁共振扫描显示了放射前的nr-axSpA,其特征是骨髓胀 (骨炎).
- 对nr-axSpA的错误诊断是令人担忧的,因为症状与其他背部疼痛原因重叠.
研究的目的:
- 为了应对诊断和定义耐火轴性脊柱关节炎的挑战.
- 提出一个框架来理解axSpA.中的治疗失败.
- 突出需要更好的诊断标准和了解治疗不响应的需要.
主要方法:
- 对有关axSpA诊断和治疗的现有文献的审查.
- 与耐火性类风湿性关节炎概念的比较.
- 根据炎症状况对耐火性axSpA进行新分类的建议.
主要成果:
- 对axSpA的准确诊断具有挑战性,误诊率很高.
- 目前的疗法在被诊断为axSpA.的患者中实现了有限的响应率 (40-50%ASAS40).
- 耐火性axSpA定义不佳,阻碍了有效的治疗评估.
结论:
- 提出了两种类型的耐火性axSpA:持续性炎症性 (PIRaxSpA) 和非炎症性 (NIRaxSpA).
- 仔细考虑错误诊断和疾病折射性对于评估治疗失败至关重要.
- 需要进一步的研究来阐明axSpA.治疗不响应的免疫学基础.
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