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美国类风湿关节炎相关干燥综合征的患病率:来自 Corrona 登记处的观察性研究。

Prevalence of Sjögren's syndrome associated with rheumatoid arthritis in the USA: an observational study from the Corrona registry.

机构信息

Corrona, LLC, 1440 Main Street, Suite 310, Waltham, MA, 02451, USA.

University of Massachusetts Medical School, Worcester, MA, USA.

出版信息

Clin Rheumatol. 2020 Jun;39(6):1899-1905. doi: 10.1007/s10067-020-05004-8. Epub 2020 Mar 4.

Abstract

The objectives of this analysis were to assess the prevalence of Sjögren's syndrome (SS) associated with rheumatoid arthritis (RA) and to compare baseline characteristics of patients with RA with and without SS. Adult patients with RA from a large observational US registry (Corrona RA), with ≥ 1 visit for assessment of SS status between 22 April 2010 and 28 February 2018, were considered. Patients with RA with versus without SS were compared. SS status was determined from a yes/no variable and reported at enrollment into the Corrona RA registry and follow-up visits. Outcomes were unadjusted prevalence of SS in patients with RA, prevalence of SS by RA disease duration, and baseline characteristics in patients with RA by SS status. Of 24,528 eligible patients, 7870 (32.1%) had a diagnosis of RA and SS. The unadjusted overall rate for SS prevalence in patients with RA was 0.30 (95% confidence interval 0.29, 0.31). SS prevalence increased with increasing RA duration. Patients with RA with versus without SS were more likely to be older, female, and seropositive; had a longer RA duration; higher disease activity; and a higher incidence of comorbidities (hypertension, cardiovascular disease, malignancies, and serious infections), erosive disease, and subcutaneous nodules at index date. Patients with RA and SS had a higher disease burden than those with RA only. The prevalence of SS increased as duration of RA increased. RA with SS was associated with seropositivity, more severe RA, extra-articular manifestations, and comorbidities.Key Points• The overall prevalence of SS among patients with RA was 30%.• The prevalence of SS increased with increasing RA disease duration.• Identifying specific clinical characteristics of patients with RA with SS, such as a greater incidence of extra-articular manifestations and comorbidities, may help clinicians to better characterize this patient population.

摘要

本分析旨在评估与类风湿关节炎(RA)相关的干燥综合征(SS)的患病率,并比较有和无 SS 的 RA 患者的基线特征。纳入了来自大型美国观察性注册研究(Corrona RA)的成年 RA 患者,这些患者在 2010 年 4 月 22 日至 2018 年 2 月 28 日期间至少有 1 次评估 SS 状态的就诊。比较了有和无 SS 的 RA 患者。SS 状态由 yes/no 变量确定,并在 Corrona RA 注册登记和随访就诊时报告。结果为 RA 患者中 SS 的未调整患病率、按 RA 病程长短的 SS 患病率以及 SS 状态下 RA 患者的基线特征。在 24528 名合格患者中,7870 名(32.1%)患有 RA 和 SS。RA 患者中 SS 的未调整总体患病率为 0.30(95%置信区间 0.29,0.31)。SS 患病率随 RA 病程的延长而增加。与无 SS 的 RA 患者相比,有 SS 的 RA 患者更可能年龄较大、女性、血清阳性;RA 病程更长;疾病活动度更高;并且更易合并高血压、心血管疾病、恶性肿瘤和严重感染、侵蚀性疾病以及在索引日期时存在皮下结节等并发症。有 SS 的 RA 患者的疾病负担高于仅有 RA 的患者。随着 RA 病程的延长,SS 的患病率增加。SS 与 RA 相关的 RA 与血清阳性、更严重的 RA、关节外表现和合并症有关。重点:

  1. 类风湿关节炎患者中 SS 的总体患病率为 30%。

  2. SS 的患病率随 RA 病程的延长而增加。

  3. 确定有 SS 的 RA 患者的特定临床特征,例如关节外表现和合并症的发生率更高,可能有助于临床医生更好地描述这一患者人群。

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