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难以管理和不耐治疗的轴性SpA的频率:使用最近的ASAS定义,从德国RABBIT-SpA注册中获得的见解

Fabian Proft¹, Stephanie Lembke², Anja Weiß²

¹Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.

Rheumatology (Oxford, England)

|December 3, 2025

概括

国际脊柱性关节炎协会 (ASAS) 的评估定义在现实世界队列中确定了难以管理的 (D2M) 和治疗阻抗 (TR) 的轴性脊柱性关节炎 (axSpA) 患者. 这些子组需要量身定制的管理策略,以获得更好的结果.

科学领域:

类风湿病学类风湿病学
免疫学免疫学免疫学
临床医学临床医学

背景情况:

轴性脊椎关节炎 (axSpA) 是一种慢性炎症性疾病.
识别难以管理 (D2M) 和难以治疗 (TR) axSpA对于有效治疗至关重要.
国际脊柱性关节炎评估协会 (ASAS) 最近提出了D2M和TR axSpA的定义.

研究的目的:

确定 axSpA 患者满足 D2M 和 TR. 的新 ASAS 标准的频率.
在首次先进治疗开始时,对D2M和TR axSpA患者的表型进行表征.

主要方法:

利用了来自德国RABBIT-SpA未来,多中心,纵向注册表的数据.
包括生物和向合成DMARD (b/tsDMARD) -先前未接受过b/tsDMARD的患者,并进行了≥12个月的随访.
应用ASAS定义来识别D2M和TR axSpA的情况.

主要成果:

在881名符合条件的axSpA患者中,9%符合D2M标准,3%符合TR标准.
D2M患者更常见的是女性,HLA-B27阴性,并出现关节炎/肠炎,但具有较少的客观炎症标志物.
与D2M/nTR患者相比,TR患者的女性和肥胖比例较低,在首次b/tsDMARD启动时,炎症症状比较频繁,如升高的CRP和MRI病变.

结论:

对于D2M和TR axSpA的ASAS定义适用于一个大,现实世界的队列.
这些定义确定了临床相关的患者子组.
对于D2M和TR axSpA患者,需要表型特定的管理策略.

关键词:

轴性脊椎关节炎轴性脊椎关节炎生物疗法是一种生物疗法.难以管理的轴SpAA 观察性研究是一种观察性研究.患者报告的结果.现实世界的数据数据.治疗失败的治疗失败.处理耐火的轴SpAA

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