银屑病性脊柱炎与强直性脊柱炎患者的临床特征：生物治疗前的基线特征。
Clinical Characteristics of Patients With Psoriatic Spondylitis Versus Those With Ankylosing Spondylitis: Features at Baseline Before Biologic Therapy.
机构信息
Department of Rheumatology, Ajou University School of Medicine, Suwon, Korea.
Office of Biostatistics, Medical Research Collaborating Center, Ajou Research Institute for Innovative Medicine, Ajou University Medical Center, Suwon, Korea.
出版信息
J Korean Med Sci. 2022 Aug 22;37(33):e253. doi: 10.3346/jkms.2022.37.e253.
BACKGROUND
Clinical characteristics and manifestations of psoriatic arthritis (PsA) have been extensively studied in western countries, yet data of Korean patients with PsA are very limited. We aimed to investigate the clinical traits of patients with PsA and dissect the characteristics of those with axial involvement.
METHODS
In this observational study, we analyzed clinical data of 109 patients with PsA who were enrolled in the Korean College of Rheumatology Biologics and Targeted Therapy registry between December 2012 and March 2022 at the time point of initiating or switching to a biologic agent. Data from 2,221 patients with ankylosing spondylitis (AS) registered during the same period were also analyzed. We divided patients with PsA into patients with or without axial involvement and then added AS patients with psoriasis (total three subgroups) for comparative analyses.
RESULTS
Asymmetric oligoarthritis was the most common clinical manifestation in patients with PsA, followed by symmetric polyarthritis and spondylitis. Our analysis indicated that methotrexate and sulfasalazine were the two most prescribed disease-modifying antirheumatic drugs for patients with PsA before starting biologic therapy. The patients with psoriatic spondylitis had more peripheral joint involvement ( = 0.016), less prior uveitis ( < 0.001), and lower human leukocyte antigen B27 (HLA-B27) positivity ( < 0.001) than the AS patients with psoriasis. Furthermore, syndesmophytes and radiographic sacroiliitis were prevalent among patients with PsA and AS patients with psoriasis who had the HLA-B27 gene.
CONCLUSION
Our study shows that the degree of peripheral arthritis is less severe in Korean patients with PsA who require biologics and reestablishes that psoriatic spondylitis is a common and important clinical pattern in Korean patients with PsA.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT01965132.
背景
西方 国家对银屑病关节炎（PsA）的临床特征和表现进行了广泛研究，但韩国 PsA 患者的数据非常有限。我们旨在研究 PsA 患者的临床特征，并剖析轴向受累患者的特征。
方法
在这项观察性研究中，我们分析了 2012 年 12 月至 2022 年 3 月期间在韩国风湿病学会生物制剂和靶向治疗登记处开始或切换至生物制剂时登记的 109 例 PsA 患者的临床数据。同时还分析了同期登记的 2221 例强直性脊柱炎（AS）患者的数据。我们将 PsA 患者分为有或无轴向受累患者，然后将银屑病 AS 患者（共三个亚组）纳入进行比较分析。
结果
不对称寡关节炎是 PsA 患者最常见的临床表现，其次是对称多关节炎和脊柱炎。我们的分析表明，甲氨蝶呤和柳氮磺胺吡啶是患者开始生物治疗前最常使用的两种改善病情抗风湿药。与银屑病 AS 患者相比，银屑病脊柱炎患者外周关节受累更多（=0.016），既往虹膜炎更少（<0.001），人类白细胞抗原 B27（HLA-B27）阳性率更低（<0.001）。此外，HLA-B27 阳性的 PsA 和银屑病 AS 患者均存在附着点炎和放射学骶髂关节炎。
结论
我们的研究表明，需要生物制剂治疗的韩国 PsA 患者外周关节炎的严重程度较低，再次证实了银屑病脊柱炎是韩国 PsA 患者常见且重要的临床类型。
试验注册
ClinicalTrials.gov 标识符：NCT01965132。
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