Charoenngam Nipith, Ponvilawan Ben, Rittiphairoj Thanitsara, Tornsatitkul Surapa, Wattanachayakul Phuuwadith, Rujirachun Pongprueth, Ungprasert Patompong
Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Department of Pharmacology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Evid Based Med. 2021 Feb;14(1):27-39. doi: 10.1111/jebm.12393. Epub 2020 Jun 15.
To investigate the association between allergic rhinitis (AR) and the risk of rheumatoid arthritis (RA).
Potentially eligible studies were identified from MEDLINE and EMBASE databases from inception to November 2019. Eligible cohort study must report relative risk with 95% confidence intervals (95% CIs) of incident RA between AR patients and comparators. Eligible case-control studies must include cases with RA and controls without RA, and must explore their history of AR. Odds ratio with 95% CIs of the association between AR and RA must be reported. Point estimates with standard errors from each study were combined using the generic inverse variance method.
A total of 21,824 articles were identified. After two rounds of the independent review by three investigators, two cohort studies and 10 case-control studies met the eligibility criteria. The pooled analysis showed no association between AR and risk of RA (RR = 0.94; 95% CI, 0.73 to 1.20; I = 84%). However, when we conducted a sensitivity analysis including only studies with acceptable quality, defined as Newcastle-Ottawa score of seven or higher, we found that patients with AR had a significantly higher risk of RA (RR = 1.36; 95% CI, 1.12 to 1.65; I = 45%).
The current systematic review and meta-analysis could not reveal a significant association between AR and RA. However, when only studies with acceptable quality were included, a significantly higher risk of RA among patients with AR than individuals without AR was observed.
探讨变应性鼻炎（AR）与类风湿关节炎（RA）风险之间的关联。
从MEDLINE和EMBASE数据库建库至2019年11月检索可能符合条件的研究。符合条件的队列研究必须报告AR患者与对照者之间RA发病的相对风险及95%置信区间（95%CI）。符合条件的病例对照研究必须包括RA病例和非RA对照，并必须探究其AR病史。必须报告AR与RA之间关联的比值比及95%CI。采用通用逆方差法合并各研究的点估计值及其标准误。
共识别出21,824篇文章。经过三位研究者两轮独立评审，两项队列研究和十项病例对照研究符合纳入标准。汇总分析显示AR与RA风险之间无关联（RR = 0.94；95%CI，0.73至1.20；I² = 84%）。然而，当我们仅对质量可接受的研究（定义为纽卡斯尔-渥太华评分≥7分）进行敏感性分析时，发现AR患者患RA的风险显著更高（RR = 1.36；95%CI，1.12至1.65；I² = 45%）。
当前的系统评价和荟萃分析未能揭示AR与RA之间存在显著关联。然而，当仅纳入质量可接受的研究时，观察到AR患者患RA的风险显著高于无AR的个体。
