伴随性疾病的模式对"难以治疗"类风湿性关节炎患者的长期功能演变和疾病活性有不同的影响
Antonios Bertsias1, Irini D Flouri1, Argyro Repa1
1Rheumatology, Clinical Immunology and Allergy Department, School of Medicine, University of Crete, Heraklion, Crete, Greece.
RMD open
|January 19, 2024
概括
难以治疗的类风湿性关节炎的结果非常不同. 心理健康和代谢状况会恶化长期预后,突出显示需要针对性干预来治疗类风湿性关节炎.
科学领域:
- 类风湿病学 类风湿病学
- 临床免疫学临床免疫学
- 纵向研究 纵向研究
背景情况:
- 了解难以治疗 (D2T) 类风湿性关节炎的长期结果至关重要.
- 影响D2T类风湿性关节炎演变的因素在很大程度上是未知的.
研究的目的:
- 探索D2T类风湿性关节炎患者长期结局的异质性.
- 确定导致D2T类风湿性关节炎演变的因素.
主要方法:
- 功能状态 (mHAQ) 和疾病活性 (DAS28) 的潜阶级轨迹分析.
- 多个线性混合模型来评估并发症影响.
- 使用EULAR对D2T的定义对一个潜在的单中心队列的分析.
主要成果:
- 19.9%的患者被确定为D2T. 预测因素包括年轻的年龄,纤维肌痛,骨关节炎和初始的DAS28-ESR.
- 观察到功能状态和疾病活动的四个不同的轨迹.
- 精神健康/疼痛相关疾病和代谢性疾病等并发症显著恶化了结果 (p<0.0001).
结论:
- D2T类类风湿性关节炎患者表现出异质的长期疾病过程.
- 针对心理健康/疼痛和代谢性并发症对于改善预后至关重要.
- 干预措施应专注于这些并发症,以优化D2T类类风湿性关节炎患者的治疗结果.
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