早期类风湿性关节炎患者的表现变化:对早期无差异性多关节炎 (EUPA) 队列进行了为期24年的研究
Nathalie Carrier1, Sophie Roux2, Ariel Masetto2
1N. Carrier, MSc, Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Sherbrooke.
The Journal of rheumatology
|September 15, 2024
概括
早期类风湿性关节炎患者的基线特征已经演变,显示出较少的血清阳性和炎症,但更多的并发症. 2011年以后,侵蚀性损伤显著下降,特别是在血清阴性个体中,这表明有利的世俗趋势.
科学领域:
- 类风湿病学 类风湿病学
- 临床流行病学 临床流行病学
背景情况:
- 早期不分化的多关节炎 (EUPA) 队列为研究早期类风湿性关节炎 (RA) 的长期趋势提供了宝贵的资源.
- 了解基线特征的变化对于解释治疗效果和预测疾病结果至关重要.
研究的目的:
- 在EUPA队列中,在24年内分析患有非常早期类风湿性关节炎 (RA) 患者基线特征的时间变化.
- 确定患者人口统计,疾病标志物和并发症的变化,这些变化可能会影响RA进展和治疗反应.
主要方法:
- 对最近出现的多关节炎符合RA分类标准的连续患者的分析,被招募到EUPA队列中.
- 患者的分层分为三个不同的时期:前生物 (1998-2004),2010年ACR/EULAR标准前 (2005-2010),以及最近十年 (2011-2022).
主要成果:
- 虽然人口统计,疾病活动得分和功能状态保持稳定,但活跃吸烟减少,心血管并发症/癌症增加.
- 血清阳性和C-反应蛋白水平从2005年开始下降,在2011年之后侵蚀性疾病的显着减少,主要是在血清阴性患者中.
- 口服皮质类固醇的使用增加,而在纳入之前的疾病修饰性抗风湿药物的使用保持稳定.
结论:
- 自2005年以来,RA患者的基线特征已经转向降低血清阳性和炎症,但增加了并发症.
- 较轻微的基线侵蚀性疾病,特别是在血清阴性患者中,自2011年以来变得明显.
- 这些长期趋势表明,对于早期RA患者来说,独立于特定干预措施的潜在更有利的轨迹.
相关概念视频
01:11Genome-wide Association Studies-GWAS
Genome-wide association studies or GWAS are used to identify whether common SNPs are associated with certain diseases. Suppose specific SNPs are more frequently observed in individuals with a particular disease than those without the disease. In that case, those SNPs are said to be associated with the disease. Chi-square analysis is performed to check the probability of the allele likely to be associated with the disease.
GWAS does not require the identification of the target gene involved in...
GWAS does not require the identification of the target gene involved in...
01:23Rheumatic Heart Disease I: Introduction
Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...