性别对肿瘤坏死因子-α抑制剂治疗反应和轴性脊柱关节炎缓解的影响。
The Sex Influence on Response to Tumor Necrosis Factor-α Inhibitors and Remission in Axial Spondyloarthritis.
机构信息
From the Dipartimento di Medicina e Scienze della Salute "Vincenzo Tiberio," Università degli Studi del Molise, Campobasso; Day Hospital of Rheumatology, Azienda Sistema Socio Sanitario (ASST) Centro Specialistico Ortopedico Traumatologico G. Pini-Centro Specialistico Traumatologico-Ortopedico (CTO), Milan; Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Matera; La Struttura Semplice Dipartimentale (SSD) di Medicina e Reumatologia, Istituto Ortopedico Rizzoli, Università di Bologna, Bologna; Rheumatology Unit, Department of Clinical and Experimental Medicine (DIMED), University of Padua, Padua; Rheumatology Unit, Azienda Ospedaliera-Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) di Reggio Emilia and Università di Modena e Reggio Emilia, Reggio Emilia, Italy.
E. Lubrano, MD, PhD, Dipartimento di Medicina e Scienze della Salute "Vincenzo Tiberio," Università degli Studi del Molise; F.M. Perrotta, MD, Dipartimento di Medicina e Scienze della Salute "Vincenzo Tiberio," Università degli Studi del Molise; M. Manara, MD, PhD, Day Hospital of Rheumatology, ASST Centro Specialistico Ortopedico Traumatologico G. Pini-CTO; S. D'Angelo, MD, PhD, Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera; O. Addimanda, MD, PhD, SSD di Medicina e Reumatologia, Istituto Ortopedico Rizzoli, Università di Bologna; R. Ramonda, MD, PhD, Rheumatology Unit, DIMED, University of Padua; L. Punzi, MD, PhD, Rheumatology Unit, DIMED, University of Padua; I. Olivieri, MD, Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera; C. Salvarani, MD, IRCCS di Reggio Emilia and Università di Modena e Reggio Emilia; A. Marchesoni, MD, PhD, Day Hospital of Rheumatology, ASST Centro Specialistico Ortopedico Traumatologico G. Pini-CTO.
出版信息
J Rheumatol. 2018 Feb;45(2):195-201. doi: 10.3899/jrheum.170666.
OBJECTIVE
The aim of this study was to evaluate the influence of sex on response to treatment and disease remission in patients with axial spondyloarthritis (axSpA).
METHODS
In this retrospective multicenter study, patients with axSpA, according to the Assessment of Spondyloarthritis international Society (ASAS) criteria for axSpA, and treated with adalimumab, etanercept, golimumab, or infliximab, were studied. We compared clinical characteristics, patient-reported outcomes, disease activity, function, and response to treatment in male and female patients with this disease.
RESULTS
Three hundred forty patients with axSpA (270 with ankylosing spondylitis, 19 with psoriatic arthritis with axial involvement, and 51 with nonradiographic axSpA) were studied. Male subjects had a significantly higher prevalence of grade IV sacroiliitis, higher levels of serum C-reactive protein, lower Maastricht Ankylosing Spondylitis Enthesitis Score, and fatigue when compared with females. Further, Kaplan-Meier survival curves showed that the rate of partial remission, ASAS40 response, and Ankylosing Spondylitis Disease Activity Score (ASDAS) major improvement, but not ASDAS inactive disease, were significantly lower in female patients.
CONCLUSION
Our data suggest that female sex was associated with a lower rate of response to treatment and of disease remission in patients with axSpA treated with antitumor necrosis factor-α drugs.
目的
本研究旨在评估性别对轴性脊柱关节炎（axSpA）患者治疗反应和疾病缓解的影响。
方法
在这项回顾性多中心研究中，根据 axSpA 的评估强直性脊柱炎国际协会（ASAS）标准，对接受阿达木单抗、依那西普、戈利木单抗或英夫利昔单抗治疗的 axSpA 患者进行了研究。我们比较了男性和女性 axSpA 患者的临床特征、患者报告的结局、疾病活动度、功能以及对治疗的反应。
结果
共研究了 340 例 axSpA 患者（270 例强直性脊柱炎、19 例伴轴向受累的银屑病关节炎和 51 例非放射学 axSpA）。与女性相比，男性受试者骶髂关节炎分级 IV 更常见，血清 C 反应蛋白水平更高，马斯特里赫特强直性脊柱炎附着点炎评分更低，疲劳感更严重。此外，Kaplan-Meier 生存曲线显示，与女性相比，部分缓解、ASAS40 反应和强直性脊柱炎疾病活动度评分（ASDAS）显著改善的患者比例较低，但 ASDAS 无疾病活动的患者比例较低。
结论
我们的数据表明，女性性别与接受抗肿瘤坏死因子-α 药物治疗的 axSpA 患者的治疗反应率和疾病缓解率较低有关。
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