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与ANA相关的关节炎:为篮子试验群体的临床和生物标志物表征

Jack Arnold^1,2, Lucy M Carter^1,2, Md Yuzaiful Md Yusof^1,2

¹Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.

Rheumatology (Oxford, England)

|August 1, 2024

概括

这项研究发现,肌肉骨炎症在与ANA相关的类风湿性疾病中很常见. 定义ANA相关性关节炎为临床试验和治疗创造了更同质的患者群体.

科学领域:

风湿病学和免疫学
自免疫性疾病自免疫性疾病
肌肉骨健康肌肉骨健康

背景情况:

与抗核抗体 (ANA) 相关的类风湿性和肌肉骨性疾病 (RMDs) 涵盖了一系列疾病,包括SLE,初级SS,硬皮病,炎症性肌肉炎,MCTD和UCTD.
肌肉骨系统 (MSK) 炎症是这些ANA相关的RMD中常见且重要的问题.

研究的目的:

为了确定MSK炎症的患病率,称为ANA关联关节炎,在ANA关联RMD患者的多样群体中.
评估MSK炎症在不同ANA相关RMD诊断中的临床影响.
提出新的患者分组 (篮子分组) 并分析其免疫学概况.

主要方法:

一项观察性研究收集了人口统计数据,并发症,疗法,疾病活性评分 (BILAG,SLEDAI,ESSDAI,VAS),患者报告的结果 (SF36,FACIT-Fatigue,EQ5D,ICECAP-A,WPAI,VAS) 和生物标志物 (基因表达,流细胞计,自身抗体) 资料.
用高斯混合模型 (GMM) 来进行患者重组.
现有和新定义的患者集群的临床和免疫特征进行了比较.

主要成果:

在ANA相关RMD的294名患者中,有213名患者出现了炎症性MSK症状.
在患有ANA相关关节炎的患者中,大多数临床变量在诊断之间是相似的,除了EQ5D-5L指数和移动性,在MCTD/pSS中较低.
GMM确定了两个群体:高MSK疾病活性 (n=89) 和低MSK疾病活性 (n=124). 高活性集群显示出更活跃的关节胀,更高的普雷迪尼索隆使用,更高的PGA,以及特定的自身抗体/生物标志物阳性.

结论:

与现有的RMD分类相比,ANA相关性关节炎代表了更具临床和免疫学同质性的患者群体.
这一定义的群体更为普遍,更适合临床试验和治疗开发.

关键词:

一个小小的东西.斯约格伦综合征是什么意思关节炎是一种关节炎.自身免疫性疾病自身免疫性疾病肌肉性肌肉性炎症肌肉性肌肉炎

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