Guiot Julien, Henket Monique, Ernst Marie, Seidel Laurence, Winandy Marie, Denis Anna, Frix Anne-Noëlle, Gester Fanny, Thys Marie, Giltay Laurie, Garah Omaima, Njock Makon-Sébastien, Canivet Perrine, Meunier Paul, Corhay Jean-Louis, Regnier Céline, Malaise Olivier, Malaise Michel, Louis Renaud
Department of Respiratory Medicine, CHU Liège, Liège, Belgium.
Biostatistics and Research Method Center (B-STAT), CHU Liège, Liège, Belgium.
Front Med (Lausanne). 2023 Mar 9;10:1063012. doi: 10.3389/fmed.2023.1063012. eCollection 2023.
In our study, we explored the specific subgroup of patients with rheumatoid arthritis (RA) suffering from obstructive lung disease (OLD) and its impact on morbi-mortality.
Our retrospective study included 309 patients suffering from RA with either obstructive (O-RA) or non-obstructive patterns (non-O-RA). OLD was defined based on the Tiffeneau index at the first available pulmonary functional test (PFT). Survival was then calculated and represented by a Kaplan-Meier curve. The comparison between the populations considered was performed by the Log-Rank test.
Out of the 309 RA patients, 102 (33%) had airway obstruction. The overall survival time was significantly lower in the O-RA group than in the non-O-RA group ( = 207) ( < 0.001). The median survival time was 11.75 years in the O-RA group and higher than 16 years in the non-O-RA group. Multivariate analysis identified OLD as an independent risk factor for mortality (HR 2.20; 95% CI 1.21-4.00, < 0.01).
Airway obstruction can be an independent risk factor of mortality in RA and should be considered as an early marker of poor prognosis. Further prospective longitudinal studies are required in order to determine the best clinical management for O-RA patients.
在我们的研究中，我们探索了患有阻塞性肺病（OLD）的类风湿关节炎（RA）患者的特定亚组及其对疾病死亡率的影响。
我们的回顾性研究纳入了309例患有阻塞性（O-RA）或非阻塞性模式（非O-RA）类风湿关节炎的患者。OLD根据首次可用肺功能测试（PFT）时的蒂芬诺指数定义。然后计算生存率并用Kaplan-Meier曲线表示。所考虑人群之间的比较通过对数秩检验进行。
在309例类风湿关节炎患者中，102例（33%）存在气道阻塞。O-RA组的总生存时间显著低于非O-RA组（=207）（<0.001）。O-RA组的中位生存时间为11.75年，非O-RA组高于16年。多变量分析确定OLD是死亡率的独立危险因素（HR 2.20；95%CI 1.21-4.00，<0.01）。
气道阻塞可能是类风湿关节炎患者死亡的独立危险因素，应被视为预后不良的早期标志物。需要进一步的前瞻性纵向研究以确定O-RA患者的最佳临床管理方法。
