Thomas Konstantinos, Lazarini Argiro, Kaltsonoudis Evripidis, Drosos Alexandros, Papalopoulos Ioannis, Sidiropoulos Prodromos, Katsimbri Pelagia, Boumpas Dimitrios, Tsatsani Panagiota, Gazi Sousana, Fragkiadaki Kalliopi, Tektonidou Maria, Sfikakis Petros P, Pantazi Lina, Boki Kyriaki A, Grika Eleftheria P, Vlachoyiannopoulos Panagiotis G, Karagianni Konstantina, Sakkas Lazaros I, Dimitroulas Theodoros, Garyfallos Alexandros, Kassimos Dimitrios, Evangelatos Gerasimos, Iliopoulos Alexios, Areti Maria, Georganas Constantinos, Melissaropoulos Konstantinos, Georgiou Panagiotis, Vounotrypidis Periklis, Ntelis Konstantinos, Mavragani Clio P, Bournazos Ilias, Katsifis Gikas, Mavrommatis Christos, Kitas George D, Vassilopoulos Dimitrios
Joint Rheumatology Program, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
Rheumatology Clinic, University of Ioannina, Ioannina, Greece.
Mediterr J Rheumatol. 2018 Mar 19;29(1):27-37. doi: 10.31138/mjr.29.1.27. eCollection 2018 Mar.
To evaluate the current disease characteristics, treatment and comorbidities of rheumatoid arthritis (RA) in Greece.
Multicenter, cross-sectional study with a 9-month recruitment period between 2015 and 2016. Demographics, disease characteristics, treatment and comorbidities were collected via a web-based platform.
2.491 RA patients were recruited: 96% from tertiary referral centers, 79% were females with a mean age of 63.1 years and disease duration of 9.9 years. Fifty-two percent were rheumatoid factor and/or anti-CCP positive, while 41% had erosive disease. Regarding treatment, 82% were on conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs), 42% on biologic DMARDs (TNFi: 22%, non-TNFi: 20%) and 40% on corticosteroids (mean daily dose: 5.2 mg). Despite therapy, 36% of patients had moderate and 12% high disease activity. The most frequent comorbidities were hypertension (42%), hyperlipidemia (33%), osteoporosis (29%), diabetes mellitus (15%) and depression (12%). Latent tuberculosis infection (positive tuberculin skin test or interferon gamma release assay) was diagnosed in 13 and 15.3% of patients, respectively. Regarding chronic viral infections, 6.2% had history of herpes zoster while 2% and 0.7% had chronic hepatitis B and C virus infection, respectively. A history of serious infection was documented in 9.6%. Only 36% and 52% of the participants had ever been vaccinated against pneumococcus and influenza virus, respectively.
This is one of the largest epidemiologic studies providing valuable data regarding the current RA characteristics in Greece. Half of patients were seropositive but despite therapy, half displayed residual disease activity, while preventive vaccination was limited.
评估希腊类风湿关节炎（RA）的当前疾病特征、治疗情况及合并症。
多中心横断面研究，招募期为2015年至2016年的9个月。通过基于网络的平台收集人口统计学信息、疾病特征、治疗情况及合并症。
共招募了2491例RA患者：96%来自三级转诊中心，79%为女性，平均年龄63.1岁，病程9.9年。52%的患者类风湿因子和/或抗环瓜氨酸肽抗体呈阳性，41%有侵蚀性疾病。在治疗方面，82%的患者使用传统合成改善病情抗风湿药（csDMARDs），42%使用生物DMARDs（肿瘤坏死因子抑制剂：22%，非肿瘤坏死因子抑制剂：20%），40%使用皮质类固醇（平均每日剂量：5.2毫克）。尽管接受了治疗，仍有36%的患者疾病活动度为中度，12%为高度。最常见的合并症为高血压（42%）、高脂血症（33%）、骨质疏松症（29%）、糖尿病（15%）和抑郁症（12%）。分别有13%和15.3%的患者被诊断为潜伏性结核感染（结核菌素皮肤试验或干扰素γ释放试验阳性）。关于慢性病毒感染，6.2%的患者有带状疱疹病史，2%和0.7%的患者分别有慢性乙型和丙型肝炎病毒感染史。9.6%的患者有严重感染史。分别只有36%和52%的参与者曾接种过肺炎球菌疫苗和流感病毒疫苗。
这是提供希腊当前RA特征有价值数据的最大规模流行病学研究之一。一半患者血清学呈阳性，但尽管接受了治疗，仍有一半患者表现出残留疾病活动度，而预防性疫苗接种有限。
