Ahlstrand I, Thyberg I, Falkmer T, Dahlström Ö, Björk M
School of Health Sciences, Jönköping University , Jönköping , Sweden.
Scand J Rheumatol. 2015;44(4):259-64. doi: 10.3109/03009742.2014.997285. Epub 2015 Mar 19.
To study differences regarding pain and activity limitations during the 3 years following diagnosis in women and men with contemporary treated early RA compared with their counterparts who were diagnosed 10 years earlier.
This study was based on patients recruited to the Early Intervention in RA (TIRA) project. In the first cohort (TIRA-1) 320 patients were included in time for diagnosis during 1996-1998 and 463 patients were included in the second cohort (TIRA-2) during 2006-2009. Disease activity, pain intensity (Visual Analogue Scale, VAS), bodily pain (BP) in the 36-item Short Form Health Survey (SF-36), activity limitations (Health Assessment Questionnaire, HAQ), and medication were reported at inclusion and at follow-up after 1, 2, and 3 years.
Disease activity, pain, and activity limitations were pronounced at inclusion across both genders and in both cohorts, with some improvement observed during the first year after diagnosis. Disease activity did not differ between cohorts at inclusion but was significantly lower at the follow-ups in the TIRA-2 cohort, in which the patients were prescribed traditional disease-modifying anti-rheumatic drugs (DMARDs) and biological agents more frequently. In TIRA-2, patients reported significantly lower pain and activity limitations at all follow-ups, with men reporting lower pain than women. Women reported significantly higher activity limitations at all time points in TIRA-2.
Pain and activity limitations were still pronounced in the contemporary treated early RA cohort compared with their counterparts diagnosed 10 years earlier and both of these factors need to be addressed in clinical settings.
研究与10年前被诊断的患者相比,当代接受治疗的早期类风湿关节炎(RA)女性和男性在诊断后3年内疼痛和活动受限情况的差异。
本研究基于招募至类风湿关节炎早期干预(TIRA)项目的患者。在第一个队列(TIRA - 1)中,1996 - 1998年期间有320名患者及时纳入诊断,2006 - 2009年期间有463名患者纳入第二个队列(TIRA - 2)。在纳入时以及1年、2年和3年随访时报告疾病活动度、疼痛强度(视觉模拟量表,VAS)、36项简短健康调查问卷(SF - 36)中的身体疼痛(BP)、活动受限情况(健康评估问卷,HAQ)以及用药情况。
在两个队列的男女患者纳入时,疾病活动度、疼痛和活动受限情况都很明显,在诊断后的第一年有一些改善。纳入时两个队列的疾病活动度没有差异,但在TIRA - 2队列的随访中显著更低,该队列患者更频繁地使用传统抗风湿药物(DMARDs)和生物制剂。在TIRA - 2中,所有随访时患者报告的疼痛和活动受限显著更低,男性报告的疼痛低于女性。在TIRA - 2中,女性在所有时间点报告的活动受限显著更高。
与10年前被诊断的患者相比,当代接受治疗的早期类风湿关节炎队列中的疼痛和活动受限情况仍然很明显,这两个因素在临床环境中都需要得到解决。