van Delft E T A M, Jamal Maha, den Braanker Hannah, Kuijper T M, Hazes J M W, Lopes Barreto Deirisa, Weel-Koenders A E A M
Department of Rheumatology, Maasstad Hospital, Rotterdam, Netherlands.
Department of Rheumatology, Erasmus Medical Centre, Rotterdam, Netherlands.
Front Med (Lausanne). 2022 Aug 24;9:933884. doi: 10.3389/fmed.2022.933884. eCollection 2022.
To classify patients with rheumatoid arthritis (RA) in an earlier stage of the disease, the ACR/EULAR classification criteria were updated in 2010. These criteria might have led to an increased incidence of RA in the rheumatology clinic. Since a higher incidence increases the socio-economic burden of RA, it is worthwhile to evaluate whether there is a time effect.
A systematic review was conducted using Embase, Medline Ovid, Cochrane Central, and Web of Science from database inception to February 2021. Included were only articles that addressed incidence rates of rheumatoid arthritis from rheumatology outpatient clinics.
Of the 6,289 publications only 243 publications on RA were found eligible for full-text review. Nine studies were included reporting incidence. The pooled incidence for RA was 11% (95% CI 6-16%) per year. Over time the incidence increased after the introduction of the 2010 ACR/EULAR classification criteria. Overall there was a high intragroup heterogeneity ( = 97.93%, < 0.001), caused by geographical area, study design and differences in case definitions.
Although the incidence seems to increase after the introduction of the 2010 ACR/EULAR criteria, no conclusions can be drawn on this time effect due to heterogeneity.
为了在类风湿关节炎（RA）疾病的更早期阶段对患者进行分类，美国风湿病学会（ACR）/欧洲抗风湿病联盟（EULAR）分类标准于2010年进行了更新。这些标准可能导致了风湿病门诊中RA发病率的增加。由于更高的发病率会增加RA的社会经济负担，因此评估是否存在时间效应是值得的。
从数据库建立至2021年2月，使用Embase、Medline Ovid、Cochrane Central和Web of Science进行了系统综述。纳入的仅为涉及风湿病门诊类风湿关节炎发病率的文章。
在6289篇出版物中，仅发现243篇关于RA的出版物符合全文审查条件。纳入了9项报告发病率的研究。RA的合并发病率为每年11%（95%置信区间6 - 16%）。随着时间推移，在引入2010年ACR/EULAR分类标准后发病率有所增加。总体而言，组内异质性较高（I² = 97.93%，P < 0.001），这是由地理区域、研究设计和病例定义差异导致的。
尽管在引入2010年ACR/EULAR标准后发病率似乎有所增加，但由于异质性，无法就此时间效应得出结论。
