Ruscitti Piero, Feist Eugen, Canon-Garcia Viviam, Rabijns Hilde, Toennessen Katrin, Bartlett Chris, Gregg Emily, Miller Paul, McGonagle Dennis
Department of Applied Clinical Sciences and Biotechnology, Rheumatology Unit, University of L'Aquila, L'Aquila, Italy.
Helios Specialist Clinic Vogelsang-Gommern, Department of Rheumatology, Helios Fachklinik, Sophie-von-Boetticher-Straße 1, 39245, Vogelsang-Gommern, Germany.
Semin Arthritis Rheum. 2023 Dec;63:152264. doi: 10.1016/j.semarthrit.2023.152264. Epub 2023 Sep 26.
Adult-onset Still's disease (AOSD) poses a not well estimated burden on patients and healthcare systems. To assess this burden, a systematic review (SR) was undertaken to identify health-related quality of life (HRQoL), utilities, costs and healthcare resource use data. Searches of twelve databases, four conferences, and three key technology assessment and regulatory agency websites were conducted in August 2022. Reference lists of retrieved SRs published since 2017 were also checked. Overall, 16 studies were eligible for inclusion. Eight studies reported HRQoL outcomes, one of which also reported utilities data. Two studies reported direct costs outcomes, and seven reported healthcare resource use data. No indirect costs were identified. A range of outcomes were reported, thus limiting the comparability of results across studies. SF-36 data were impaired in AOSD on most scales, especially those concerning physical activity. Mean SF-36 data were lower across all subscales in patients with active AOSD compared with inactive AOSD. Biologic therapy showed improvements in the SF-36 physical health summary. Utility scores (one study) were significantly lower for AOSD than for healthy controls. Limited direct economic costs data were identified but were substantial where reported. Hospital length of stay ranged from 6.1 to 23.5 days. The SR showed there is a paucity of research reporting the HRQoL and cost burden of AOSD.
成人斯蒂尔病（AOSD）给患者和医疗系统带来了难以准确估计的负担。为评估这一负担，我们进行了一项系统评价（SR），以确定与健康相关的生活质量（HRQoL）、效用、成本和医疗资源使用数据。2022年8月，我们检索了12个数据库、4个会议以及3个关键技术评估和监管机构网站。我们还查阅了自2017年以来发表的检索到的系统评价的参考文献列表。总体而言，有16项研究符合纳入标准。8项研究报告了HRQoL结果，其中1项还报告了效用数据。2项研究报告了直接成本结果，7项报告了医疗资源使用数据。未发现间接成本。报告了一系列结果，因此限制了各研究结果的可比性。在大多数量表上，AOSD患者的SF-36数据受损，尤其是那些与身体活动有关的量表。与非活动性AOSD患者相比，活动性AOSD患者所有子量表的平均SF-36数据更低。生物治疗使SF-36身体健康总结有所改善。AOSD患者的效用得分（一项研究）显著低于健康对照组。发现的直接经济成本数据有限，但报告的数据相当可观。住院时间从6.1天到23.5天不等。该系统评价表明，关于AOSD患者的HRQoL和成本负担的研究很少。
