Cañete Juan D, Tasende Jose Antonio Pinto, Laserna Francisco José Rebollo, Castro Susana Gómez, Queiro Rubén
Arthritis Unit, Rheumatology Department, Hospital Clínic-IDIBAPS, Barcelona, Spain.
Rheumatology Department, Complexo Hospitalario Universitario de A Coruña-INIBIC, A Coruña, Spain.
Rheumatol Ther. 2020 Jun;7(2):237-257. doi: 10.1007/s40744-020-00202-x. Epub 2020 Apr 8.
A systematic literature review was conducted with the aim to analyse the impact of comorbidity on patient-reported outcomes (PROs) in patients with psoriatic arthritis (PsA).
A sensitive search strategy of the Medline, Embase and the Cochrane Library (up to March 2019) was applied to retrieve studies for inclusion in this systematic literature review. Abstracts of the ACR and EULAR scientific meetings were also searched. The selection criteria were: (1) patients with PsA (population) with a comorbidity (intervention) and (2) report of any impact of the comorbidity on PROs. Systematic literature reviews, randomized controlled trials and observational were included in this systematic literature review. Two of the authors selected the articles and collected the data.
Eighteen articles were included in this systematic literature review, with most being cross-sectional studies that included more than 9000 patients with PsA. Some studies analysed the impact of an individual comorbidity, such as fibromyalgia (FM), and in others the analysis was according to the number of comorbidities. The most frequently analysed PROs were function, quality of life and fatigue. Analysis of the studies included in the review showed that patients with a higher number of comorbidities and/or more severe comorbidities reported worse impacts of their disease on function, patient's global assessment (PGA), pain, fatigue, work disability and quality of life. Specifically, FM had a negative impact on the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), function, quality of sleep and quality of life; anxiety and depression had a negative impact on function and fatigue; metabolic syndrome had a negative impact on BASDAI, function, PGA and quality of life; obesity had a negative impact on function and pain; smoking (current and ex-smokers) had a negative impact on pain, function, fatigue, quality of life and overall health; alcohol intake had a negative impact on pain, function, fatigue, quality of life and overall health.
The prevalence and impact of medical comorbidity on PROs are very high in patients with PsA.
进行了一项系统的文献综述，旨在分析合并症对银屑病关节炎（PsA）患者报告结局（PROs）的影响。
采用对Medline、Embase和Cochrane图书馆（截至2019年3月）的敏感检索策略，检索纳入本系统文献综述的研究。还检索了美国风湿病学会（ACR）和欧洲抗风湿病联盟（EULAR）科学会议的摘要。选择标准为：（1）患有合并症（干预措施）的PsA患者（人群），以及（2）关于合并症对PROs的任何影响的报告。本系统文献综述纳入了系统文献综述、随机对照试验和观察性研究。两位作者选择文章并收集数据。
本系统文献综述纳入了18篇文章，大多数为横断面研究，纳入了9000多名PsA患者。一些研究分析了个体合并症的影响，如纤维肌痛（FM），而其他研究则根据合并症的数量进行分析。分析最多的PROs是功能、生活质量和疲劳。对纳入综述的研究分析表明，合并症数量较多和/或病情较严重的患者报告其疾病对功能、患者整体评估（PGA）、疼痛、疲劳、工作残疾和生活质量的影响更差。具体而言，FM对巴斯强直性脊柱炎疾病活动指数（BASDAI）、功能、睡眠质量和生活质量有负面影响；焦虑和抑郁对功能和疲劳有负面影响；代谢综合征对BASDAI、功能、PGA和生活质量有负面影响；肥胖对功能和疼痛有负面影响；吸烟（当前吸烟者和既往吸烟者）对疼痛、功能、疲劳、生活质量和整体健康有负面影响；饮酒对疼痛、功能、疲劳、生活质量和整体健康有负面影响。
在PsA患者中，医疗合并症对PROs的患病率和影响非常高。
