Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH); Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education,, No.1 Shuaifuyuan, Dongcheng district, 100730, Beijing, China.
National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, 300191, Tianjin, China.
Curr Rheumatol Rep. 2022 Aug;24(8):247-258. doi: 10.1007/s11926-022-01079-1. Epub 2022 Jul 13.
This review aims to emphasize interesting and important new findings with a focus on the spectrum of spondyloarthritis (SpA) in China.
Over the past decade, significant advances have been made in the investigation of SpA epidemiology, the exploration of genetic and environmental risk factors, the identification of clinical features, and the updating of treatment protocols in the Chinese population. The prevalence of ankylosing spondylitis (AS) in China is 0.20-0.42%, and the prevalence of HLA-B27 in AS patients is 88.8-89.4%. HLA-B2704 is the most common subtype in Chinese AS patients, followed by HLA-B2705. HLA-A01, more precisely HLA-A01:01, may be associated with psoriatic arthritis (PsA). Tumor necrosis factor inhibitors and IL-17A inhibitors have been shown to be effective and safe for AS patients in China. Juvenile-onset AS is relatively rare, accounting for only 9.1% of the AS population. The prevalence of arthritis related to inflammatory bowel disease is 6.9 to 7.2%. A Chinese study showed that the most frequently prescribed medication was methotrexate (66.4%). Biological agents were prescribed in only16.4% of patients with PsA. This review summarizes the latest research in the epidemiology, pathogenesis, clinical manifestations, and management of SpA among Chinese populations. Multiple HLA associations with SpA have also been described, and it is hoped that discoveries of such ethnic-specific risk factor(s) and understanding of their pathological mechanisms may potentially lead to newer targeted therapies for the Chinese populations worldwide.
本篇综述旨在强调与中国人群中脊柱关节炎(SpA)相关的有趣且重要的新发现,涵盖 SpA 的多个方面。
在过去十年中,中国在 SpA 的流行病学研究、遗传和环境危险因素的探索、临床特征的确定以及治疗方案的更新等方面取得了显著进展。中国强直性脊柱炎(AS)的患病率为 0.20-0.42%,AS 患者的 HLA-B27 阳性率为 88.8-89.4%。中国 AS 患者中最常见的 HLA-B27 亚型是 HLA-B2704,其次是 HLA-B2705。HLA-A01,更确切地说是 HLA-A*01:01,可能与银屑病关节炎(PsA)相关。肿瘤坏死因子抑制剂和 IL-17A 抑制剂在中国 AS 患者中被证实是有效且安全的。少关节型幼年特发性关节炎在中国较为少见,仅占 AS 患者的 9.1%。炎症性肠病相关关节炎的患病率为 6.9%至 7.2%。一项中国研究显示,柳氮磺胺吡啶是最常被开的药物(66.4%)。生物制剂仅在 16.4%的 PsA 患者中被开具。本篇综述总结了中国人群中 SpA 的流行病学、发病机制、临床表现和管理的最新研究进展。还描述了多个与 SpA 相关的 HLA 关联,希望发现此类特定种族的危险因素及其病理机制,可能为全球中国人群带来新的靶向治疗。