类风湿性关节炎患者在生物治疗开始时与年龄相关的差异:来自大型回顾性队列研究的见解
Sanjot Sunner1, Britney Jones1, C Allyson Jones1
1Faculty of Medicine & Dentistry, University of Alberta, MacKenzie Health Sciences Center, 2J2.00 Walter C, Edmonton, AB, T6G2R7, Canada.
Clinical rheumatology
|August 11, 2025
概括
老年类类风湿性关节炎 (RA) 患者在开始使用生物修饰性抗风湿药物 (bDMARDs) 时面临显著的延迟,导致结果更差. 解决这些与年龄相关的差异对于公平的RA治疗至关重要.
科学领域:
- 类风湿病学 类风湿病学
- 老年医学 老年医学
- 药物治疗 药物治疗
背景情况:
- 风湿性关节炎 (RA) 是一种常见的慢性炎症性疾病,在老年人群中发病率越来越高.
- 生物修饰性抗风湿药物 (bDMARDs) 是有效的RA治疗方法,但它们在不同年龄段的发病模式需要检查.
研究的目的:
- 为了比较bDMARD在年轻 (<65岁) 和老年 (≥65岁) RA患者之间的处方模式.
- 确定导致bDMARD治疗开始延迟的因素,在RA的老年人中.
主要方法:
- 从RAPORT注册表中对RA患者的回顾性分析.
- 使用DAS28和HAQ分数评估疾病活动.
- 多变量回归以确定延迟bDMARD处方的预测因素.
主要成果:
- 老年人与年轻患者相比,bDMARD启动的延迟显著更长 (p<0.0001).
- 老年患者呈现出更高的疾病活性 (HAQ,DAS28) 和升高的炎症标志物.
- 晚年,并发症,吸烟和血清阳性与延迟开始使用bDMARD有关.
结论:
- 对老年RA患者bDMARD治疗的显著延迟有助于低于最佳的疾病控制和不良结果.
- 解决与年龄相关的障碍对于公平获得有效的RA治疗至关重要.
- 需要进一步的研究来了解治疗差异和及时bDMARDs对老年人的长期结果的影响.
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