Department of Immunology and Medicine, St. Marianna University School of Medicine, Sugao 2-16-1, Miyamae-ku, Kawasaki, 216-8511, Japan.
Institute of Medical Science, St. Marianna University School of Medicine, Kawasaki, 216-8511, Japan.
Sci Rep. 2022 Jan 10;12(1):465. doi: 10.1038/s41598-021-04493-0.
We conducted retrospective cohort studies of patients with relapsing polychondritis (RP) twice in 2009 and 2019, using a physician questionnaire. We compared the patients' clinical statuses between the years. Age and gender were comparable between the two surveys. Mean disease duration was longer in 2019 survey (8.3 years) than that in 2009 survey (4.8 years, P < 0.001). The mortality rate declined in 2019 survey compared with those in 2009 survey (from 9.2 to 1.6%, P < 0.001). Incidence of airway involvement decreased in 2019 survey compared with that in 2009 survey (from 49 to 37%, P = 0.012). In 2019 survey, we found more frequent use of biological agents and immunosuppressants in patients with airway involvement. When we focused on RP patients with airway involvement, physicians in 2019 chose methotrexate and calcineurin inhibitors preferentially, compared with azathioprine and cyclophosphamide. Of note is that increased use of infliximab was observed in RP patients with airway involvement, but not in those without. Reduction of airway involvement and mortality in patients with RP was observed in 2019 survey. The reduction may associate with the frequent use of biologics including infliximab in RP patients with airway involvement.
我们在 2009 年和 2019 年两次进行了复发性多软骨炎(RP)患者的回顾性队列研究,使用医生问卷。我们比较了这两年患者的临床状况。两次调查的年龄和性别无差异。2019 年调查的平均疾病持续时间(8.3 年)长于 2009 年调查(4.8 年,P<0.001)。2019 年调查的死亡率低于 2009 年调查(从 9.2%降至 1.6%,P<0.001)。2019 年调查中气道受累的发生率低于 2009 年调查(从 49%降至 37%,P=0.012)。在 2019 年调查中,我们发现有更多气道受累的患者使用了生物制剂和免疫抑制剂。当我们关注有气道受累的 RP 患者时,2019 年的医生更倾向于选择甲氨蝶呤和钙调磷酸酶抑制剂,而不是硫唑嘌呤和环磷酰胺。值得注意的是,在有气道受累的 RP 患者中观察到英夫利昔单抗的使用增加,但在无气道受累的患者中没有。在 2019 年调查中,RP 患者的气道受累和死亡率有所下降。这种减少可能与气道受累的 RP 患者频繁使用包括英夫利昔单抗在内的生物制剂有关。