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与类风湿性关节炎相比,牛皮性关节炎患者的诊断延迟和不那么密集的治疗:在英语和威尔士语审计数据集中嵌入的一项研究

Rachel A Charlton¹, Emer Gates², Laura C Coates³

¹Department of Life Sciences, University of Bath, Bath, UK.

Annals of the rheumatic diseases

|March 30, 2025

概括

与类风湿性关节炎 (RA) 患者相比,患有牛皮性关节炎 (PsA) 的患者经历了更长的诊断延迟,并且接受的疾病修饰性抗风湿药物 (DMARD) 较少,这表明潜在的治疗不足和较差的结果.

科学领域:

类风湿病学类风湿病学
临床免疫学临床免疫学
流行病学流行病学

背景情况:

牛皮关节炎 (PsA) 和类风湿性关节炎 (RA) 是慢性炎症疾病,需要及时诊断和治疗.
诊断的延迟可能导致疾病活动增加和患者的治疗结果较差.

研究的目的:

为了比较患有PsA和RA的患者之间的诊断时间.
为了比较PSA与RA患者的初始治疗策略和疾病结果.

主要方法:

从国家早期炎症性关节炎审计 (2018年5月至2019年10月) 中确定了患有PsA的患者,并根据年龄和性别与RA患者匹配1: 1.
比较包括患者特征,诊断的时间,疾病活动和治疗开始,重点是多关节性心脏病.

主要成果:

患有PsA的患者在转诊前症状持续时间更长,从全科医生 (GP) 介绍到诊断的时间更长 (112天vs89天).
在转诊之前和在PsA患者的二次护理中观察到诊断延迟.
在基线时,与RA患者 (69.0%) 相比,PsA患者的病变修饰性抗风湿药物 (DMARD) 处方较少 (54.0%).
虽然RA患者的基线疾病活性较高,但PsA患者在3个月后在28个关节中显示出更高的平均疾病活动评分.

结论:

与RA患者相比,PsA患者面临更长的诊断延迟.
对PsA患者的DMARD开始较少,并在3个月后观察到疾病活动的改善较低,这表明潜在的治疗不足.
一个治疗到目标的策略通常是商定的,但它的实施可能对PSA来说是不理想的.

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