Health Psychology Section, King's College London, London, United Kingdom.
Health Psychology Section, King's College London, London, United Kingdom.
Semin Arthritis Rheum. 2020 Apr;50(2):209-219. doi: 10.1016/j.semarthrit.2019.08.006. Epub 2019 Aug 24.
To conduct a systematic review and longitudinal meta-analysis of early rheumatoid arthritis (RA) cohorts with long-term data on pain, fatigue or mental well-being.
Searches using PUBMED, EMBASE and PyscInfo were performed to identify all early RA cohorts with longitudinal measures of pain, fatigue or mental well-being, along with clinical measures. Using longitudinal meta-analyses, the progression of each outcome over the first 60-months was estimated. Cohorts were stratified based on the median recruitment year to investigate secular trends in disease progression.
Of 7,319 papers identified, 75 met the inclusion criteria and 46 cohorts from 41 publications provided sufficient data on 18,046 patients for meta-analysis. The Disease Activity Scores (DAS28) and the Short-Form 36 (SF-36) Physical Component Score (PCS) indicated that post-2002 cohorts had statistically significant improvements over the first 60-months compared to pre-2002 cohorts, with standardised mean differences (SMD) of 0.86 (95% Confidence Intervals 0.34 to 1.37) and 0.76 (95% CI 0.25 to 1.27) respectively at month-60. However, post-2002 cohorts indicated statistically non-significant improvements in pain, fatigue, functional disability and SF-36 Mental Component Score (MCS) compared to pre-2002 cohorts, with SMD of 0.24 (95% CI -0.25 to 0.74), 0.38 (95% CI -0.11 to 0.88), 0.34 (95% CI -0.15-0.84) and -0.08 (95% CI -0.41 to 0.58) at month-60 respectively.
Recent cohorts indicate improved levels of disease activity and physical quality of life, however this has not translated into similar improvements in levels of pain, fatigue and functional disability by 60-months.
对具有长期疼痛、疲劳或心理健康数据的早期类风湿关节炎（RA）队列进行系统回顾和纵向荟萃分析。
使用 PUBMED、EMBASE 和 PyscInfo 进行检索，以确定所有具有纵向疼痛、疲劳或心理健康测量以及临床测量的早期 RA 队列。使用纵向荟萃分析，估计每个结局在最初 60 个月的进展情况。根据中位招募年份对队列进行分层，以研究疾病进展的时间趋势。
在 7319 篇论文中，有 75 篇符合纳入标准，41 篇论文中的 46 个队列提供了足够的 18046 名患者的数据进行荟萃分析。疾病活动评分（DAS28）和简明 36 健康调查（SF-36）生理成分评分（PCS）表明，与 2002 年前的队列相比，2002 年后的队列在最初 60 个月内有统计学意义的改善，标准均数差（SMD）分别为 0.86（95%置信区间 0.34 至 1.37）和 0.76（95%置信区间 0.25 至 1.27）在第 60 个月。然而，与 2002 年前的队列相比，2002 年后的队列在疼痛、疲劳、功能障碍和 SF-36 心理成分评分（MCS）方面的改善没有统计学意义，SMD 分别为 0.24（95%置信区间-0.25 至 0.74）、0.38（95%置信区间-0.11 至 0.88）、0.34（95%置信区间-0.15 至 0.84）和-0.08（95%置信区间-0.41 至 0.58）在第 60 个月。
最近的队列表明疾病活动和生理生活质量水平有所改善，但到 60 个月时，疼痛、疲劳和功能障碍水平并没有类似的改善。
