潜在的难以治疗的牛皮关节炎现实世界的患病率和促成因素
Gülay Alp1, Mete Kara2, Haluk Cinakli3
1Rheumatology Clinic, Bingöl State Hospital, Bingöl, Turkey. gulay_alp88@hotmail.com.
难以治疗的牛皮关节炎 (D2TPsA) 影响了19.3%的患者. 伴随性疾病,如纤维肌痛和糖尿病,以及HLA-B27阳性,是与D2TPsA相关的关键因素.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 临床医学 临床医学
背景情况:
- 牛皮关节炎 (PsA) 对许多患者来说,在实现低疾病活性或缓解方面存在重大挑战.
- 复杂的发病因子和PSA的各种组织参与需要专门的定义,持续的疾病活动和治疗调整.
- 这项研究旨在确定患有潜在难以治疗的PsA (D2TPsA) 的患者,并与风湿性关节炎的现有定义进行并行.
研究的目的:
- 为了评估患者队列中难以治疗的牛皮关节炎 (D2TPsA) 的频率.
- 确定与D2TPsA.A.相关的促成因素和患者特征.
- 探索并发症对PsA治疗耐药性的影响.
主要方法:
- 在两个高等教育中心进行了一项回顾性研究.
- 潜在的D2TPsA被定义为对至少一种常规合成疾病修饰性抗风湿药物 (DMARD) 和至少两种具有不同作用机制的生物或向性合成DMARD反应的失败.
- 分析了来自171名PsA患者的数据.
主要成果:
- 难以治疗的牛皮关节炎 (D2TPsA) 在19.3%的患者中被发现 (171人中有33人).
- 患有D2TPsA的患者表现出更长的疾病持续时间,更高的疾病负担 (包括DAPSA得分),以及增加HLA-B27阳性和外周参与的患病率.
- 伴随性疾病如纤维肌痛 (FM) 和糖尿病 (DM),以及较高的伴随性疾病中位数,在D2TPsA组中明显更为普遍. FM,DM和HLA-B27阳性独立与D2TPsA相关.
结论:
- 伴随性疾病显著影响牛皮关节炎疾病的活动和治疗结果.
- 进一步的研究至关重要,以区分由并发症引起的治疗挑战和PsA真正的治疗耐药性.
- 这些发现强调需要对患者进行全面的评估,同时考虑PsA管理中的并发症.
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