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通过患者报告结局衡量的疾病负担:银屑病关节炎比类风湿关节炎感觉更严重吗?一项全国性横断面研究。

Disease burden measured by patient-reported outcomes: does psoriatic arthritis feel worse than rheumatoid arthritis? A cross-sectional nationwide study.

作者信息

Weman Lauri, Salo Henri, Kuusalo Laura, Huhtakangas Johanna, Vähäsalo Paula, Backström Maria, Kärki Johanna, Sokka-Isler Tuulikki

机构信息

University of Eastern Finland, and Jyväskylä Central Hospital, Jyväskylä, Finland.

Data and Analytics, Finnish Institute for Health and Welfare (THL), Helsinki, Finland.

出版信息

Clin Exp Rheumatol. 2023 Nov;41(11):2177-2181. doi: 10.55563/clinexprheumatol/h9hn90. Epub 2023 May 15.

Abstract

OBJECTIVES

To study the subjective disease burden of patients with psoriatic arthritis (PsA) and rheumatoid arthritis (RA), using patient-reported outcomes (PROs) cross-sectionally.

METHODS

Data of 3598 patients with PsA and 13913 with RA were extracted from the database. Measures included the VAS-values of pain, fatigue and patient global assessment (PGA), HAQ, and disease activity at the most recent visit/remote contact in the period 1.2020 to 9.2021. Values were compared between patients with PsA and RA overall, and by sex and age (<50, 50-59, 60-69 and ≥70 years). Regression analyses were applied.

RESULTS

The overall median (IQR)-values for pain were 29 (10, 56) for PsA and 26 (10, 51) for RA, 29 (9, 60) and 28 (8, 54) for fatigue, 28 (10, 52) and 29 (11, 51) for PGA, 0.4 (0, 0.9) and 0.5 (0, 1.0) for HAQ (p<0.001 for all comparisons; adjusted for sex and age). The median (IQR)-values for pain, fatigue, PGA and HAQ were higher for PsA vs. RA in most age groups for males and females. All PROs were higher in older patients with both diagnoses. The median values for DAS28, doctor global assessment, ESR and CRP were 1.9 vs. 2.0, 8 vs. 8, 7 vs. 8 and 2 vs. 3 in PsA and RA, respectively.

CONCLUSIONS

Overall, both PsA and RA groups showed moderate disease control by patients' perspective, but the burden of disease was higher especially in women with PsA compared to RA. Disease activity was similar and low in both diseases.

摘要

目的

采用患者报告结局(PROs)进行横断面研究,以了解银屑病关节炎(PsA)和类风湿关节炎(RA)患者的主观疾病负担。

方法

从数据库中提取3598例PsA患者和13913例RA患者的数据。测量指标包括疼痛、疲劳和患者整体评估(PGA)的视觉模拟评分(VAS)值、健康评估问卷(HAQ)以及2020年1月至2021年9月期间最近一次就诊/远程联系时的疾病活动度。对PsA和RA患者的总体值进行比较,并按性别和年龄(<50岁、50 - 59岁、60 - 69岁和≥70岁)进行比较。应用回归分析。

结果

PsA患者疼痛的总体中位数(四分位间距)值为29(10,56),RA患者为26(10,51);疲劳分别为29(9,60)和28(8,54);PGA分别为28(10,52)和29(11,51);HAQ分别为0.4(0,0.9)和0.5(0,1.0)(所有比较p<0.001;经性别和年龄校正)。在大多数年龄组中,男性和女性的PsA患者疼痛、疲劳、PGA和HAQ的中位数(四分位间距)值均高于RA患者。两种诊断的老年患者所有PROs均更高。PsA和RA患者的28关节疾病活动评分(DAS28)、医生整体评估、红细胞沉降率(ESR)和C反应蛋白(CRP)的中位数分别为1.9对2.0、8对8、7对8和2对3。

结论

总体而言,从患者角度看,PsA和RA组疾病控制均为中等,但与RA相比,PsA患者尤其是女性的疾病负担更高。两种疾病的疾病活动度相似且较低。

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