Savadogo Binta, Fahed Hanna, Sellam Jérémie, Georgin-Lavialle Sophie, Fautrel Bruno, Mitrovic Stéphane
Rheumatology Department, Sorbonne University-APHP, Pitié-Salpêtrière Hospital, Paris, France.
Rheumatology Department, Sorbonne University-APHP, CRSA INSERM 938, Saint-Antoine Hospital, Paris, France.
Semin Arthritis Rheum. 2025 Jun 6;74:152762. doi: 10.1016/j.semarthrit.2025.152762.
AA amyloidosis (AAA) is a complication of chronic inflammation; the burden is expected to decrease with recent therapies. We conducted a systematic review of the incidence, prevalence, mortality and response to treatment of inflammatory joint disease (IJD)-related AAA.
MEDLINE, EMBASE and Cochrane library databases were searched until October 2024. Selected studies were prospective and retrospective cohorts as well as case series (≥ 10 patients) of histologically proven AAA occurring in IJD.
From 1094 articles identified, we included 33. Substantial heterogeneity among studies was observed. Most studies (75.8 %) were published before 2010. No clear trend was identifiable in AAA incidence and mortality during the last decades. AAA prevalence rates in rheumatoid arthritis ranged from 16.7 % to 25.2 % before 2010 and decreased to 0.7 % after 2010, which suggests a potential positive role of biologic therapies. Similarly, AAA prevalence rates in ankylosing spondylitis ranged from 6.1 % to 8.5 % before 2010 and 1.1 % to 1.3 % after 2010. Immunomodulating therapies (especially biologics) seemed to improve values of AAA biomarkers, such as glomerular filtration rate and serum amyloid A level.
Our work highlights the need for more recent and comprehensive population-based epidemiological data to decipher the actual IJD-related AAA burden.
AA型淀粉样变性（AAA）是慢性炎症的一种并发症；随着近期治疗方法的出现，预计其负担会减轻。我们对炎症性关节病（IJD）相关AAA的发病率、患病率、死亡率及治疗反应进行了系统评价。
检索MEDLINE、EMBASE和Cochrane图书馆数据库至2024年10月。入选的研究为前瞻性和回顾性队列研究以及IJD中经组织学证实的AAA的病例系列研究（≥10例患者）。
从检索到的1094篇文章中，我们纳入了33篇。研究之间存在显著的异质性。大多数研究（75.8%）发表于2010年之前。在过去几十年中，AAA的发病率和死亡率没有明显趋势。类风湿关节炎中AAA的患病率在2010年之前为16.7%至25.2%，2010年之后降至0.7%，这表明生物治疗可能具有积极作用。同样，强直性脊柱炎中AAA的患病率在2010年之前为6.1%至8.5%，2010年之后为1.1%至1.3%。免疫调节治疗（尤其是生物制剂）似乎能改善AAA生物标志物的值，如肾小球滤过率和血清淀粉样蛋白A水平。
我们的工作强调需要更新、更全面的基于人群的流行病学数据，以解读实际的IJD相关AAA负担。
