风湿性关节炎和中风风险之间的关系
Alicia Shin1, Seonyoung Kang2, Jin-Hyung Jung3
1University of California, Los Angeles, USA.
概括
风湿性关节炎 (RA) 患者面临较高的缺血性和出血性中风风险. 血清阳性RA患者的中风风险高于血清阴性RA患者,这凸显了针对性合成疾病修饰性抗性药物 (tsDMARD) 的进一步研究的需要.
科学领域:
- 关节病学
- 神经学
- 流行病学
背景情况:
- 风湿性关节炎 (RA) 与中风风险增加有关,但血清状况和中风亚型的区别尚不清楚.
- 生物和向性合成修饰性抗风湿药物 (b/ tsDMARDs) 对RA患者中风风险的影响需要进一步调查.
研究的目的:
- 调查类风湿性关节炎 (RA) 与缺血性中风 (IS) 和出血性中风 (HS) 的风险之间的联系.
- 在血清阳性RA (SPRA) 和血清阴性RA (SNRA) 患者之间比较中风风险.
- 评估b/ tsDMARDs对RA患者中风风险的影响.
主要方法:
- 通过韩国国家医疗保险服务数据库进行全国性队列研究.
- 包括在2010年至2017年间诊断的45175名RA患者,没有先前的中风病史.
- 与135,525个匹配的非RA对照进行比较.
主要成果:
- 与对照组相比,RA患者的IS (aHR 1.47) 和HS (aHR 1.31) 风险显著增加.
- 与SNRA患者相比,SPRA患者的IS (aHR1. 56) 和HS (aHR1. 40) 的风险更高.
- 在使用生物DMARD (bDMARD) 和非使用者之间没有发现中风风险的显著差异;然而,在使用有针对性的合成DMARD (tsDMARD) 时,观察到降低风险的趋势 (aHR为0. 81).
结论:
- 风湿性关节炎患者的IS和HS风险显著增加.
- 与血清阴性RA相比,血清阳性RA与较高的中风风险有关.
- 需要进行进一步的研究,以探索 tsDMARDs 降低 RA 患者中风风险的潜力.
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