亚临床巨细胞动脉炎增加了多发性肌痛类风湿复发的风险
Eugenio De Miguel1, Rositsa Karalilova2, Pierluigi Macchioni3
1Rheumatology, La Paz University Hospital, Madrid, Spain eugenio.demiguel@gmail.com.
Annals of the rheumatic diseases
|November 6, 2023
概括
患有亚临床巨细胞动脉炎 (GCA) 的多发性肌痛性风湿症 (PMR) 患者经历了更多的复发. 较低的初始葡萄糖皮质体剂量和快速逐渐减少增加了PMR与亚临床GCA的复发风险.
科学领域:
- 类风湿病学 类风湿病学
- 内部医学 内部医学
- 临床免疫学临床免疫学
背景情况:
- 多发性肌痛性风湿症 (PMR) 是一种常见的炎症性疾病.
- 巨细胞动脉炎 (GCA) 在PMR患者中可能存在亚临床.
- 在PMR中识别亚临床GCA对于最佳管理至关重要.
研究的目的:
- 评估PMR患者中亚临床GCA的临床意义.
- 为了确定PMR与亚临床GCA的最佳治疗策略.
- 为了比较单独的PMR和PMR与亚临床GCA之间的结果.
主要方法:
- 150名PMR患者根据超声波被分为孤立的PMR或PMR与亚临床GCA组.
- 患者被跟踪2年,监测复发和治疗.
- 包括葡萄糖皮质醇使用和DMARDs在内的结果在各组之间进行了比较.
主要成果:
- 亚临床GCA患者的复发率 (62%) 与单独的PMR (16%) 相比显著更高.
- 较低的初始普得尼松剂量和在3个月内迅速逐渐减少与亚临床GCA的复发有关.
- 在复发和非复发的亚临床GCA患者之间没有发现年龄,性别,CRP或ESR的差异.
结论:
- 在PMR患者中,亚临床GCA导致复发的风险显著增加.
- 较低的葡萄糖皮质体初始剂量和在前3个月的加速逐渐减少是复发的危险因素.
- 这些发现突显了针对PMR与亚临床GCA进行量身定制的葡萄皮质激素管理的重要性.
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