中国系统性红斑狼疮治疗与研究协作组(CSTAR)2009 - 2019年注册研究:中国系统性红斑狼疮患者的主要临床特征
Chinese SLE Treatment and Research Group (CSTAR) Registry 2009-2019: Major Clinical Characteristics of Chinese Patients with Systemic Lupus Erythematosus.
作者信息
Li Mengtao, Wang Yanhong, Zhao Jiuliang, Wang Qian, Wang Ziqian, Tian Xinping, Zeng Xiaofeng
机构信息
Department of Rheumatology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Chinese Rheumatism Data Center (CRDC), Chinese SLE Treatment and Research Group (CSTAR), Beijing, China of Rheumatology, Peking Union Medical College Hospital, Beijing, China.
Department of Epidemiology and Biostatistics, Peking Union Medical College, Beijing, China.
出版信息
Rheumatol Immunol Res. 2021 Apr 13;2(1):43-47. doi: 10.2478/rir-2021-0001. eCollection 2021 Mar.
OBJECTIVE
To describe the overall clinical characteristics of patients from the Chinese SLE Treatment and Research group (CSTAR) registry in the past 10 years.
METHODS
CSTAR registry originated as a multicenter, consecutive, and prospective design launched in 2009. The data were collected online from 304 rheumatology centers, which covered 30 provinces in China. All data were generated and uploaded in the clinic directly without secondary collection, including demographic, clinical manifestations, disease activity (SLEDAI-2K) and organ damage evaluation (SLICC Damage Index), and lab test results. Biological samples were preserved for future study. Meanwhile, data cleaning and validation were managed by a professional backstage statistician.
RESULTS
A total of 25,147 SLE patients were registered up to Dec 2019. The mean age of disease onset was 31.2 years with the age of confirmed diagnosis at 32.1 years. The male to female rate was 1:11.9. 4.6% were pediatric patients. The most common clinical presentations at entry were oral ulcer (59.4%), arthritis (55.0%), alopecia (43.22%), skin rash (40.0%), and nephritis (33.5%). The mean SLEDAI score at entry was 4 and 32.6% were in moderate to severely active disease. 66.4% and 37.8% of patients were positive for anti-ds-DNA antibody or low complement level. Additionally, 1.1% of patients were with pulmonary arterial hypertension (PAH). The prevalence rate of cerebrovascular disease was 0.3%. A total of 58.2% of patients were in clinical remission when thery were registered.
CONCLUSIONS
The CSTAR registry is the largest ongoing SLE registry in China so far. More than 25,000 SLE patients are registered and nearly 10,000 are in follow-up visits. This registry has provided high-quality data for future studies and will become an infrastructure for domestic and international collaborations.
目的
描述中国系统性红斑狼疮治疗与研究组(CSTAR)登记系统中患者在过去10年的总体临床特征。
方法
CSTAR登记系统始于2009年开展的一项多中心、连续性、前瞻性设计。数据通过网络从覆盖中国30个省份的304个风湿病中心收集。所有数据均在临床直接生成并上传,无需二次收集,包括人口统计学信息、临床表现、疾病活动度(SLEDAI-2K)和器官损伤评估(SLICC损伤指数)以及实验室检查结果。生物样本被保存以备后续研究。同时,由专业的后台统计人员进行数据清理和验证。
结果
截至2019年12月,共登记了25147例系统性红斑狼疮患者。疾病发病的平均年龄为31.2岁,确诊年龄为32.1岁。男女比例为1:11.9。4.6%为儿童患者。入组时最常见的临床表现为口腔溃疡(59.4%)、关节炎(55.0%)、脱发(43.22%)、皮疹(40.0%)和肾炎(33.5%)。入组时SLEDAI评分的平均值为4分,32.6%的患者处于中度至重度活动期疾病。66.4%和37.8%的患者抗双链DNA抗体阳性或补体水平降低。此外,1.1%的患者患有肺动脉高压(PAH)。脑血管疾病的患病率为0.3%。登记时共有58.2%的患者处于临床缓解状态。
结论
CSTAR登记系统是目前中国最大的正在进行的系统性红斑狼疮登记系统。登记了超过25000例系统性红斑狼疮患者,近10000例正在接受随访。该登记系统为未来研究提供了高质量的数据,并将成为国内外合作的基础设施。