Corrona, LLC, 1440 Main Street, Suite 310, Waltham, MA, 02451, USA.
University of Massachusetts Medical School, Worcester, MA, USA.
Rheumatol Int. 2020 Aug;40(8):1239-1248. doi: 10.1007/s00296-020-04602-8. Epub 2020 May 24.
The objective of this study was to compare rheumatoid arthritis (RA) disease activity and patient-reported outcomes (PROs) in a national sample of patients with RA with/without Sjögren's syndrome (SS). Adults with RA from a large observational US registry (Corrona RA) with known SS status between 22 April 2010 and 31 July 2018 and a visit 12 (± 3) months after index date were identified (n = 36,256/52,757). SS status: determined from a yes/no variable reported at enrolment into the Corrona RA registry and follow-up visits. Index date: date that SS status was recorded (yes/no). Patients received biologic or targeted synthetic disease-modifying antirheumatic drugs as part of standard care. Patients with RA only were followed for ≥ 12 months to confirm the absence of SS. Patients were frequency- and propensity-score matched (PSM) 1:1 and stratified by disease duration and treatment response-associated variables, respectively. Clinical Disease Activity Index (CDAI) and PROs 12 months after index visit were compared in patients with and without SS. Baseline characteristics in 283 pairs of PSM patients were balanced. Mean change in CDAI score was numerically lower in patients with RA and SS than patients with RA only (8.8 vs 9.3). Reductions in PROs of pain, fatigue and stiffness were two- to threefold lower for patients with RA and SS versus RA only. Reductions in RA disease activity and RA-related PROs were lower in patients with RA and SS versus those with RA only. Our data indicate that SS adds to treatment challenges; physicians may wish to consider SS status when managing patients with RA.
本研究旨在比较伴有/不伴有干燥综合征（SS）的类风湿关节炎（RA）患者的疾病活动度和患者报告的结局（PROs）。从大型美国观察性注册研究（Corrona RA）中确定了 2010 年 4 月 22 日至 2018 年 7 月 31 日期间已知 SS 状态的、具有 RA 的成年人，并在索引日期后 12（±3）个月进行了随访（n=36256/52757）。SS 状态：根据 Corrona RA 注册研究和随访期间登记的是/否变量确定。索引日期：记录 SS 状态的日期（是/否）。患者接受生物制剂或靶向合成疾病修饰抗风湿药物作为标准治疗的一部分。仅患有 RA 的患者接受了≥12 个月的随访，以确认是否存在 SS。患者按频率和倾向得分匹配（PSM）1:1，并分别按疾病持续时间和与治疗反应相关的变量分层。在伴有和不伴有 SS 的患者中比较了索引访问后 12 个月的临床疾病活动指数（CDAI）和 PROs。283 对 PSM 患者的基线特征平衡。与仅患有 RA 的患者相比，患有 RA 和 SS 的患者的 CDAI 评分的平均变化数值较低（8.8 对 9.3）。患有 RA 和 SS 的患者的疼痛、疲劳和僵硬 PRO 降低了两到三倍，而仅患有 RA 的患者则降低了三到四倍。与仅患有 RA 的患者相比，患有 RA 和 SS 的患者的 RA 疾病活动度和 RA 相关 PRO 降低。我们的数据表明，SS 增加了治疗的挑战；医生在治疗 RA 患者时可能希望考虑 SS 状态。
