Centre for Interdisciplinary Clinical Immunology, Rheumatology and Autoimmune Diseases and Internal Medicine II, University Hospital Tübingen, Tübingen, Germany.
Department of Rheumatology, Faculty of Medicine, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
Rheumatol Int. 2024 Mar;44(3):497-507. doi: 10.1007/s00296-023-05508-x. Epub 2024 Jan 5.
The aim of this study is to present the current care situation of patients with giant cell arteritis (GCA), Takayasu arteritis (TAK), ANCA-associated vasculitis (AAV) and Behçet's disease (BD). Trends over the last 15 years will reflect improvements and remaining deficits in the management of vasculitides. Consecutive cross-sectional data from patients with vasculitides from the German National Database (NDB) of the Collaborative Arthritis Centres between 2007 and 2021 were included. Medication, physician- and patient-reported outcomes on disease activity and disease burden, inpatient stays and occupational participation are compared for different vasculitis entities and over time. Employment rates were compared to German population rates. Between 502 and 854 vasculitis patients were annually documented. GCA and AAV were the most common vasculitides. Median disease duration ranged from 2 to 16 years. Over the years, glucocorticoids decreased in proportion and dose, most markedly in GCA and TAK, while biologic therapies increased up to 27%. Physicians rated disease activity as low for the vast majority of patients, while patients-reported moderate outcomes in many dimensions. PROs remained largely unchanged. The proportion of employed patients (< 65 years) increased from 47 to 57%. In recent years, biologics are increasingly used in patients with vasculitides, while glucocorticoids decreased significantly. PRO's have not improved. Work participation increased but remains lower than that in the German population.
本研究旨在介绍巨细胞动脉炎（GCA）、Takayasu 动脉炎（TAK）、抗中性粒细胞胞浆抗体相关性血管炎（AAV）和贝赫切特病（BD）患者的当前治疗情况。过去 15 年的趋势反映了血管炎管理方面的改善和仍然存在的不足。本研究纳入了 2007 年至 2021 年期间德国协作关节炎中心国家数据库（NDB）中连续的血管炎患者横断面数据。比较了不同血管炎实体和不同时间的药物治疗、医生和患者报告的疾病活动和疾病负担、住院和职业参与情况。将就业率与德国人口比率进行比较。每年记录的血管炎患者人数在 502 至 854 人之间。GCA 和 AAV 是最常见的血管炎。中位疾病持续时间从 2 年到 16 年不等。多年来，糖皮质激素的比例和剂量逐渐减少，在 GCA 和 TAK 中最为明显，而生物制剂的使用增加了 27%。医生认为绝大多数患者的疾病活动度低，而患者在许多方面报告了中度结果。PROs 基本保持不变。年龄在 65 岁以下的患者就业率从 47%增加到 57%。近年来，生物制剂在血管炎患者中的使用越来越多，而糖皮质激素的使用明显减少。PRO 没有改善。工作参与度有所增加，但仍低于德国人口。
