Gamez-Guijarro Maria, Reinoso-Cobo Andres, Perez-Galan Maria Jose, Ortega-Avila Ana Belen, Ramos-Petersen Laura, Torrontegui-Duarte Marcelino, Gijon-Nogueron Gabriel, Lopezosa-Reca Eva
Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, Arquitecto Francisco Peñalosa 3, Ampliación de Campus de Teatinos, 29071 Malaga, Spain.
Department of Rheumatology, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain.
Healthcare (Basel). 2024 Aug 20;12(16):1656. doi: 10.3390/healthcare12161656.
Approximately 90% of patients with arthritis exhibit forefoot deformities, including deformities within the metatarsophalangeal and proximal interphalangeal joints. Current pharmacological treatment with Disease Modifying Antirheumatic Drugs (DMARDs) consists of two groups: synthetic drugs (sDMARDs) and biological drugs (bDMARDs). The objective of our study was to investigate foot anthropometry changes in RA patients based on the administered treatment over a five-year period Method: A longitudinal analysis was conducted with RA patients who were grouped based on their pharmacological treatment. The pharmacological treatment groups were categorized into (I) methotrexate (MTX), (II) MTX plus biological treatments (including all variables), (III) biological treatment alone, and (IV) a miscellaneous group comprising patients with diverse treatments, including patients for whom various drugs had failed or who had not achieved remission with pharmacological treatment. For the anthropometric measurements, a foot measurement platform validated by McPoil et al. was used. Post hoc analyses with Bonferroni correction were performed to identify pairwise differences between the treatment groups while controlling for Type I errors due to multiple comparisons. Results: In the period from 2018 to 2023, significant changes were observed in several foot measurements. For instance, the MTX group showed a statistically significant increase in left heel width ( = 0.026). The MTX group experienced a slight increase in left foot length, while the Biologics and MTX + Bio groups exhibited more substantial increases in both maximum medial arch height and midfoot width. Conclusions: Different RA treatments can have a significant impact on foot structure over a five-year period, showing notable changes in heel width and overall foot morphology. Combined treatments with MTX and biologics potentially offer better management of RA.
约90%的关节炎患者存在前足畸形，包括跖趾关节和近端指间关节内的畸形。目前使用改善病情抗风湿药（DMARDs）的药物治疗分为两组：合成药物（sDMARDs）和生物药物（bDMARDs）。我们研究的目的是基于五年的给药治疗情况，调查类风湿关节炎（RA）患者足部人体测量学的变化。方法：对根据药物治疗分组的RA患者进行纵向分析。药物治疗组分为：（I）甲氨蝶呤（MTX）组，（II）MTX加生物治疗组（包括所有变量），（III）单纯生物治疗组，以及（IV）杂项组，该组包括接受各种不同治疗的患者，包括各种药物治疗失败或未通过药物治疗实现缓解的患者。对于人体测量，使用了经McPoil等人验证的足部测量平台。进行了Bonferroni校正的事后分析，以确定治疗组之间的两两差异，同时控制因多次比较导致的I型错误。结果：在2018年至2023年期间，观察到多项足部测量有显著变化。例如，MTX组左脚跟宽有统计学意义的增加（ = 0.026）。MTX组左脚长度略有增加，而生物制剂组和MTX + 生物制剂组在最大内侧足弓高度和中足宽度上均有更显著的增加。结论：不同的RA治疗在五年期间可对足部结构产生重大影响，表现为足跟宽度和足部整体形态有明显变化。MTX与生物制剂的联合治疗可能为RA提供更好的管理。
