来自一家三级中心的意大利类风湿性关节炎患者死亡率低：抗氨甲酰化蛋白抗体低流行率的可能影响。
Low mortality rate in Italian rheumatoid arthritis patients from a tertiary center: putative implication of a low anti-carbamylated protein antibodies prevalence.
作者信息
Iacono Daniela, Favoino Elvira, Borgia Alessia, Fasano Serena, Pantano Ilenia, D'Abrosca Virginia, Picillo Giuseppe, Grembiale Rosa Daniela, Perosa Federico, Valentini Gabriele
机构信息
Department of Clinical and Experimental Medicine, Rheumatology Section, University of Campania "Luigi Vanvitelli", Naples, Italy,
Department of Biomedical Sciences and Human Oncology (DIMO), Rheumatologic and Systemic Autoimmune Diseases Unit, University of Bari Medical School, Bari, Italy.
出版信息
Open Access Rheumatol. 2018 Sep 6;10:129-134. doi: 10.2147/OARRR.S163731. eCollection 2018.
BACKGROUND AND OBJECTIVE
Anti-carbamylated protein antibodies (anti-CarP Ab) represent a novel kind of autoantibodies specificity detectable in the sera of patients with rheumatoid arthritis (RA). They have been recently reported to be associated with increased mortality in Spanish patients with RA. The aim of our study was to compare the incidence mortality rates (IMRs) detected in RA patients from a tertiary Italian center with those reported in other European tertiary centers and to evaluate the putative role of anti-CarP Ab in modulating the low IMR detected in our patients.
METHODS
Clinical charts of patients consecutively admitted to our center, from January 1, 2008, to December 31, 2014, were retrospectively reviewed. The mortality rate (expressed as the number of deaths in the cohort divided by the number of years of IMR follow-up) and causes of death were assessed at December 31, 2015. Sera of 61 patients, representative of the whole cohort, collected at the time of admission to our center were investigated for the presence and the level of anti-CarP Ab. Demographic and clinical features, mortality rates and prevalence of anti-CarP Ab in our series were compared with those reported in other European cohorts.
RESULTS
We observed 608 patients for a median of 3.51 years. All-cause and cause-specific IMRs in our cohort were significantly lower than the Better Anti-rheumatic Farmaco-therapy and the Spanish cohort, while only all-cause and cardiovascular IMRs were significantly lower in our series with respect to the Leiden Early Arthritis Clinic cohort. Anti-CarP Ab prevalence was significantly lower in our series than in any other European cohorts.
CONCLUSION
We confirm that the mortality rate is lower in our Italian RA cohort with respect to other European cohorts. Whether the low prevalence of anti-CarP Ab might be responsible for this result awaits to be furtherly investigated.
背景与目的
抗氨甲酰化蛋白抗体（anti-CarP Ab）是一类可在类风湿关节炎（RA）患者血清中检测到的新型自身抗体。最近有报道称，西班牙RA患者中该抗体与死亡率增加有关。我们研究的目的是比较意大利一家三级中心的RA患者的发病率死亡率（IMR）与其他欧洲三级中心报告的IMR，并评估抗CarP Ab在调节我们患者中检测到的低IMR方面的潜在作用。
方法
回顾性分析2008年1月1日至2014年12月31日连续入住我们中心的患者的临床病历。在2015年12月31日评估死亡率（以队列中的死亡人数除以IMR随访年数表示）和死亡原因。对我们中心入院时收集的61名代表整个队列的患者的血清进行抗CarP Ab的存在情况和水平检测。将我们系列中的人口统计学和临床特征、死亡率以及抗CarP Ab的患病率与其他欧洲队列报告的情况进行比较。
结果
我们观察了608名患者，中位观察时间为3.51年。我们队列中的全因和特定原因IMR显著低于更好的抗风湿药物治疗队列和西班牙队列，而相对于莱顿早期关节炎诊所队列，我们系列中仅全因和心血管IMR显著较低。我们系列中抗CarP Ab的患病率显著低于任何其他欧洲队列。
结论
我们证实，我们的意大利RA队列的死亡率低于其他欧洲队列。抗CarP Ab的低患病率是否可能是导致这一结果的原因有待进一步研究。
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