在24年内,类风湿性关节炎的骨质疏松症和骨质疏松性骨折的显著减少:单一中心的经验
Peter Oelzner1, Paul-Heinrich Mueller1, Tobias Hoffmann1
1Department of Internal Medicine III, Jena University Hospital - Friedrich Schiller University Jena, Jena, Germany.
RMD open
|August 20, 2024
概括
骨质疏松症和类风湿性关节炎 (RA) 患者的骨折在24年内显著减少. 这种RA骨健康的改善与增加使用生物疗法和减少使用皮质类固醇有关.
科学领域:
- 类风湿病学 类风湿病学
- 骨科 骨科是指骨科的学科.
- 药理学 药理学是指药理学的学科.
背景情况:
- 类风湿性关节炎 (RA) 是一种慢性炎症性疾病,与骨质疏松症和骨折的风险增加有关.
- RA 治疗的进步导致了改善疾病控制,可能会影响 RA 相关的骨并发症.
研究的目的:
- 在24年的时间内,调查类风湿性关节炎患者骨质疏松症和骨质疏松性骨折的发生率的变化.
- 评估不断发展的治疗策略,包括生物药物和葡萄皮质类药物,对RA骨健康的影响.
主要方法:
- 从1996年到2019年,对1086名RA患者的数据进行了回顾性分析.
- 根据治疗期,患者被分为两个队列:1996-2004 (n=539) 和2005-2019 (n=547).
- 骨矿物质密度 (BMD) 和骨折数据在队列之间进行了比较;使用线性回归分析了BMD的预测因素.
主要成果:
- 骨质疏松症的患病率显著下降,从第1组的48.4%降至第2组的28.3% (p<0.001).
- 骨质疏松性外周和脊椎骨折也显示显著下降 (11.5%对21%,p<0.001;和6.6%对10.9%,p=0.011,分别).
- 生物制剂治疗显著增加 (5.0%与19.7%,p<0.001),而葡萄糖皮质类药物使用在第2队列下降,与更高的BMD相关联.
结论:
- 在RA患者的骨质疏松症和骨质疏松性骨折的显著减少在24年内被观察到.
- 2005年至2019年间生物疗法的使用增加与骨健康的这一积极趋势有关.
- 通过现代疗法改善RA疾病控制有助于减轻骨并发症.
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