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与老年类风湿关节炎患者疾病活动度控制不足相关的风险因素:一项来自全国韩国风湿病学院生物制剂(KOBIO)登记处的研究结果。

Risk factors associated with inadequate control of disease activity in elderly patients with rheumatoid arthritis: Results from a nationwide KOrean College of Rheumatology BIOlogics (KOBIO) registry.

机构信息

Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

Division of Rheumatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

出版信息

PLoS One. 2018 Oct 16;13(10):e0205651. doi: 10.1371/journal.pone.0205651. eCollection 2018.

Abstract

OBJECTIVE

The proportion of elderly patients with rheumatoid arthritis (RA) is continuously growing as a result of the increasing aging population. We compared disease activity between different age groups, and evaluated the clinical factors associated with high disease activity.

METHODS

This cross-sectional study analyzed the data of RA patients enrolled in the Korean College of Rheumatology Biologics registry (KOBIO-RA) between 2012 and 2014. Disease activity between elderly (age ≥ 65 years) and non-elderly patients (age < 65 years) was compared, and the association of clinical factors with high disease activity was assessed using a multivariate logistic regression model.

RESULTS

Of 1,227 patients in KOBIO-RA, 244 patients with RA were aged 65 years or over. In elderly patients, the proportion of men was higher (P = 0.012), and the duration of disease was longer (P < 0.001) compared with non-elderly patients. The elderly group showed a higher incidence of comorbidity (P < 0.001), and less use of methotrexate (P = 0.004). Assessment of disease activity using various composite measures showed a higher proportion of high disease activity in elderly patients than non-elderly patients. Longer disease duration, presence of comorbidity, and non-use of methotrexate were independently associated with high disease activity (P = 0.002, P < 0.001, and P = 0.029, respectively).

CONCLUSIONS

At enrollment of KOBIO-RA, elderly patients showed higher disease activity compared with non-elderly patients. Disease duration, use of methotrexate, and comorbidity are associated with disease activity control in Korean patients with RA.

摘要

目的

由于人口老龄化的不断增加,类风湿关节炎(RA)老年患者的比例不断增加。我们比较了不同年龄组之间的疾病活动度,并评估了与高疾病活动度相关的临床因素。

方法

本横断面研究分析了 2012 年至 2014 年期间参加韩国风湿病学院生物制剂登记处(KOBIO-RA)的 RA 患者的数据。比较了老年(年龄≥65 岁)和非老年(年龄<65 岁)患者之间的疾病活动度,并使用多变量逻辑回归模型评估了临床因素与高疾病活动度的相关性。

结果

在 KOBIO-RA 的 1227 例患者中,有 244 例 RA 患者年龄在 65 岁以上。与非老年患者相比,老年患者中男性比例更高(P=0.012),疾病病程更长(P<0.001)。老年组合并症发生率更高(P<0.001),且较少使用甲氨蝶呤(P=0.004)。使用各种综合指标评估疾病活动度,发现老年患者的高疾病活动度比例高于非老年患者。较长的病程、合并症的存在以及未使用甲氨蝶呤与高疾病活动度独立相关(P=0.002、P<0.001 和 P=0.029)。

结论

在 KOBIO-RA 登记时,老年患者的疾病活动度高于非老年患者。在韩国 RA 患者中,疾病病程、甲氨蝶呤的使用和合并症与疾病活动度控制相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/efdd/6191131/a2150fcdaa7a/pone.0205651.g001.jpg

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