难以治疗的轴性脊柱关节炎患者
Tahir Saygın Öğüt1, Funda Erbasan1, Mehmet Fatih Şahiner2
1Department of Internal Medicine, Division of Rheumatology, Akdeniz University Faculty of Medicine, Antalya, Türkiye.
Archives of rheumatology
|November 7, 2024
概括
相当一部分轴性脊柱关节炎 (AxSpA) 患者符合难以治疗 (D2T) 标准,即使使用先进疗法. 这些D2T AxSpA患者经常经历更高的疾病活性和更差的生活质量,纤维肌痛的患病率显著.
科学领域:
- 类风湿病学 类风湿病学
- 临床免疫学临床免疫学
- 患者的治疗结果.
背景情况:
- 轴性脊柱关节炎 (AxSpA) 提出了治疗挑战,尽管目前的治疗指南,但仍有一部分患者难以治疗 (D2T).
- 了解D2T AxSpA的患病率和特征对于优化患者管理和制定有针对性的干预措施至关重要.
研究的目的:
- 制定特定的标准来识别难以治疗的 (D2T) 轴性脊柱关节炎 (AxSpA) 患者.
- 为了确定D2T AxSpA在定义的患者队列中的患病率.
- 描述D2T AxSpA患者的临床和人口特征.
主要方法:
- 进行了一项涉及166名AxSpA患者 (缩性脊髓炎和非放射性AxSpA) 的横截面研究.
- 根据欧洲风湿病学协会联盟 (EULAR) 的建议,D2T标准是基于对多种生物或向合成疾病修饰性抗风湿药物 (bDMARDs/tsDMARDs) 的治疗失败而制定的.
- 在D2T和非D2T组之间比较了患者的特征,疾病活性和生活质量.
主要成果:
- 该研究发现,22.9%的AxSpA患者满足了制定的D2T标准.
- 在D2T和非D2T患者之间没有观察到基线人口统计学 (性别,年龄,诊断年龄,职业,教育) 的显著差异.
- 与非D2T患者相比,D2T患者患有纤维肌痛的患病率更高,疾病活性指数增加,急性相反应剂升高,生活质量更差.
结论:
- 相当一部分AxSpA患者符合难以治疗的标准,突出了当前治疗策略中未满足的需求.
- 纤维肌痛的存在与AxSpA.中难以治疗的表型有显著的关联.
- 尽管治疗方面取得了进展,但AxSpA患者的一个子集继续经历高疾病负担和生活质量受损.
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