Joint Rheumatology Program, National and Kapodistrian University of Athens Faculty of Medicine, Athens, Greece.
Hellenic Republic Ministry of Health, Athens, Greece.
RMD Open. 2021 Nov;7(3). doi: 10.1136/rmdopen-2021-001694.
OBJECTIVES: To compare current all-cause mortality rates in rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PsA), systemic lupus erythematosus (SLE) and systemic sclerosis (SSc) versus general population. METHODS: In this population-based, retrospective cohort study, anonymised data on 11 186 586 citizens, including all patients with RA (42 735, 79% female), AS (9707, 43% female), PsA (13 779, 55% female), SLE (10 440, 89% female) and SSc (2277, 88% female), (median age of 64/47/54/53/59 years at study entry, respectively), under prescribed treatment between 2015 and 2019, were extracted from the electronic database covering nearly 99% of the Greek population. RESULTS: After 1:5 (patients:general population) matching for gender/age, we found that survival was worse in SSc, followed by SLE and inflammatory arthritis. Compared with the general population HRs for death increased from the first 3 years to 5 years of observation possibly due to increases in disease duration: RA (from 0.63 to 1.13 (95% CI: 1.05 to 1.22), AS (from 0.62 to 1.01, (95% CI: 0.76 to 1.33)), PsA (from 0.68 to 1.06, (95% CI: 0.88 to 1.28)), SLE (from 1.52 to 1.98, (95% CI: 1.67 to 2.33)) and SSc (from 2.27 to 4.24, (95% CI: 3.19 to 5.63)). In both SLE and SSc mortality was increased in men than women and in patients younger than 50 years. CONCLUSIONS: Survival rates over 5 years in inflammatory arthritis under treatment are currently becoming comparable (AS/PsA) or slightly higher (RA) than those of the general population. However, all-cause mortality is almost twofold and fourfold higher in SLE and SSc, respectively, being even higher for male and younger patients.
目的:比较类风湿关节炎(RA)、强直性脊柱炎(AS)、银屑病关节炎(PsA)、系统性红斑狼疮(SLE)和系统性硬皮病(SSc)患者的全因死亡率与普通人群相比。
方法:在这项基于人群的回顾性队列研究中,从涵盖近 99%希腊人口的电子数据库中提取了 11186586 名公民的匿名数据,包括所有接受 RA(42735 名,79%为女性)、AS(9707 名,43%为女性)、PsA(13779 名,55%为女性)、SLE(10440 名,89%为女性)和 SSc(2277 名,88%为女性)治疗的患者(中位年龄分别为 64/47/54/53/59 岁)。这些患者于 2015 年至 2019 年期间接受处方治疗。
结果:经过性别/年龄 1:5(患者:普通人群)匹配后,我们发现 SSc 患者的生存率较差,其次是 SLE 和炎症性关节炎。与普通人群相比,死亡风险从观察的前 3 年增加到 5 年,这可能是由于疾病持续时间的增加:RA(从 0.63 增加到 1.13(95%CI:1.05 至 1.22))、AS(从 0.62 增加到 1.01(95%CI:0.76 至 1.33))、PsA(从 0.68 增加到 1.06(95%CI:0.88 至 1.28))、SLE(从 1.52 增加到 1.98(95%CI:1.67 至 2.33))和 SSc(从 2.27 增加到 4.24(95%CI:3.19 至 5.63))。在 SLE 和 SSc 中,男性和年龄小于 50 岁的患者的死亡率均高于女性。
结论:在接受治疗的炎症性关节炎患者中,5 年生存率目前已变得相当(AS/PsA)或略高(RA)于普通人群。然而,SLE 和 SSc 的全因死亡率几乎高出两倍和四倍,男性和年轻患者的死亡率更高。
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