类风湿性关节炎关节外表现的发生率下降:基于人口的队列研究

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Bradly A Kimbrough¹, Cynthia S Crowson¹, John M Davis¹

¹Mayo Clinic College of Medicine and Science, Rochester, Minnesota.

Arthritis care & research

|September 10, 2023

概括

类风湿性关节炎 (RA) 关节外表现 (ExRAs) 的发生率已经下降,但罹患患者的死亡风险仍然存在. 这项研究强调了RA并发症的发展趋势及其对生存的影响.

科学领域:

类风湿病学类风湿病学
流行病学流行病学
临床医学临床医学

背景情况:

类风湿性关节炎 (RA) 是一种慢性自身免疫性疾病,其特征是关节炎和全身性关节外表现 (ExRAs).
了解ExRA发病率的时间趋势及其与死亡率的关联对于患者管理和公共卫生战略至关重要.

研究的目的:

评估ExRAs累积发病率的变化随着时间的推移.
评估基于人口的队列中的ExRAs和死亡风险之间的关联.

主要方法:

分析了成年RA患者 (1985-2014) 的基于人口的初始队列,分为两个时期:185-1999年和2000-2014年.
手动图表审查确定了ExRA,并计算了10年的累积发病率. 考克斯的比例危险模型评估了风险因素和死亡率关联.

主要成果:

任何ExRA的10年累积发病率显著下降,从早期队列中的45.1%降至后期队列中的31.6% (P<0.001).
这种下降主要是由于皮下类类风湿结节和非严重的ExRAs的发病率降低.
风湿因子阳性和目前的吸烟被确定为ExRAs的危险因素. 在患有不重症和重症ExRA的患者中,死亡风险较高.

结论:

在类风湿性关节炎中,关节外表现的发生率在过去几十年里显著下降.
尽管发病率下降,但关节外表现仍然与RA患者的死亡风险增加有关.

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