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芬兰门诊专科诊所中类风湿关节炎患者的全国性横断面概述。

A nationwide cross-sectional overview of patients with rheumatoid arthritis followed in outpatient specialty clinics in Finland.

作者信息

Aaltonen K J, Sokka T, Möttönen T, Korpela M, Komulainen R, Uusitalo T, Salomaa S, Uutela T, Valleala H

机构信息

Faculty of Pharmacy, University of Helsinki , Helsinki , Finland.

出版信息

Scand J Rheumatol. 2014;43(4):286-90. doi: 10.3109/03009742.2013.876512. Epub 2014 Mar 24.

Abstract

OBJECTIVES

We aimed to conduct a cross-sectional overview of patients with rheumatoid arthritis (RA) in outpatient specialized clinics in Finland.

METHOD

Consecutive patients were enrolled in the study. The data collected comprised demographic, disease- and treatment-related variables.

RESULTS

Between November 2011 and May 2012, 890 patients with RA (77% female) were enrolled from 14 sites. The median age was 59.8 years and the time from diagnosis 7.2 years. Values for the Disease Activity Score using 28 joint counts (DAS28) ranged from 0.28 to 6.61 (median 2.55) with 52% and 70% of patients reaching remission and low disease activity, respectively. Rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies were evident in 70% and 63% of patients, respectively. Median Health Assessment Questionnaire (HAQ) scores with and without aids and devices were 0.75 [interquartile range (IQR) 0.13-1.38] and 0.63 (IQR 0.13-1.13), respectively. Conventional disease-modifying anti-rheumatic drugs (DMARDs) were used by 91% of patients. A triple therapy of methotrexate (MTX), hydroxychloroquine (HCQ), and sulfasalazine (SSZ) was used by 15%, other MTX-based combination by 30%, MTX alone by 20%, and other DMARDs alone or in combination by 26% of patients. In addition, glucocorticoids and biologics were taken by 58% and 21% of patients, respectively. Of the 184 biologics users, 18% were not using DMARDs concomitantly.

CONCLUSIONS

Our cross-sectional review of patients with RA revealed that > 50% of patients were in remission according to DAS28. Comparison with previous studies revealed a reduction in disease activity of prevalent RA cases, possibly resulting from increased use of aggressive anti-rheumatic treatments.

摘要

目的

我们旨在对芬兰门诊专科诊所的类风湿关节炎(RA)患者进行横断面概述。

方法

连续纳入患者进行研究。收集的数据包括人口统计学、疾病及治疗相关变量。

结果

2011年11月至2012年5月期间,从14个地点纳入了890例RA患者(77%为女性)。中位年龄为59.8岁,从诊断到入组的时间为7.2年。采用28个关节计数的疾病活动评分(DAS28)值范围为0.28至6.61(中位数为2.55),分别有52%和70%的患者达到缓解和低疾病活动度。类风湿因子(RF)和抗环瓜氨酸肽(抗CCP)抗体分别在70%和63%的患者中呈阳性。使用辅助器具和未使用辅助器具时健康评估问卷(HAQ)的中位评分分别为0.75[四分位间距(IQR)0.13 - 1.38]和0.63(IQR 0.13 - 1.13)。91%的患者使用了传统的改善病情抗风湿药物(DMARDs)。15%的患者采用甲氨蝶呤(MTX)、羟氯喹(HCQ)和柳氮磺胺吡啶(SSZ)三联疗法,30%的患者采用其他基于MTX的联合疗法,20%的患者单独使用MTX,26%的患者单独或联合使用其他DMARDs。此外,分别有58%和21%的患者使用糖皮质激素和生物制剂。在184名生物制剂使用者中,18%的患者未同时使用DMARDs。

结论

我们对RA患者的横断面回顾显示,根据DAS28,超过50%的患者处于缓解状态。与先前研究相比,现患RA病例的疾病活动度有所降低,这可能是由于积极抗风湿治疗的使用增加所致。

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