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疑似特发性免疫介导性多关节炎犬的描述性分析及复发相关因素

Descriptive Analysis and Factors Associated With Relapse in Dogs With Presumptive Idiopathic Immune-Mediated Polyarthritis.

作者信息

Pichard Diane, Robin Thibaud, Le Boedec Kevin, Maurey Christelle, Kurtz Maxime, Da Riz Fiona, Blot Stéphane, Canonne-Guibert Morgane, Cervone Mario, Krafft Emilie, Cadore Jean-Luc, Desquilbet Loïc, Benchekroun Ghita

机构信息

Ecole Nationale Veterinaire d'Alfort-CHUV-AC, Maisons-Alfort, France.

Centre Hospitalier Veterinaire Fregis-IVC Evidensia France, Service de Médecine Interne, Paris, France.

出版信息

J Vet Intern Med. 2025 Sep-Oct;39(5):e70241. doi: 10.1111/jvim.70241.

Abstract

BACKGROUND

Immune-mediated polyarthritis (IMPA) is a joint disease common in dogs. Although its prognosis is generally favorable, relapses are frequent, and predictive factors for relapse remain poorly characterized.

OBJECTIVES

To evaluate the outcome of medical management of IMPA in dogs and identify predictive factors for relapse.

ANIMALS

Client-owned dogs diagnosed with non-associative IMPA between 2010 and 2022 across four veterinary referral centers.

METHODS

This was a retrospective multicentric study. The data collected at the time of diagnosis, including signalment, clinical presentation, imaging, and laboratory findings, and treatments, were analyzed. Relapse was defined as the recurrence of clinical signs, CRP levels above the reference range, or both after remission. Associations with time from remission to relapse were assessed using univariate and multivariable Cox models.

RESULTS

Among 119 dogs, 114 (95.8%) achieved remission. Among the 85 dogs with relapse data, the median time to relapse was 6.5 months, with relapse rates of 43% at 6 months, 61% at 12 months, and 65% at 24 months. In the multivariable analysis, thrombocytosis (adjusted hazard ratio [aHR] = 5.5 [2.0-15.0], p < 0.001), lymphadenomegaly (aHR = 4.0 [1.5-11], p = 0.006) and lameness (aHR = 3.9 [1.2-12.2], p = 0.02) at initial admission were independently and significantly associated with time from remission to relapse.

CONCLUSION

This study highlights a favorable clinical outcome for dogs with non-associative IMPA with high remission rates but substantial relapse risks. Lameness, lymphadenomegaly, and thrombocytosis are associated with a greater risk of relapse.

摘要

背景

免疫介导性多关节炎(IMPA)是犬类常见的关节疾病。尽管其预后总体良好,但复发频繁,复发的预测因素仍未得到充分描述。

目的

评估犬IMPA药物治疗的结果,并确定复发的预测因素。

动物

2010年至2022年期间,在四个兽医转诊中心诊断为非关联性IMPA的客户拥有的犬只。

方法

这是一项回顾性多中心研究。分析了诊断时收集的数据,包括信号、临床表现、影像学和实验室检查结果以及治疗方法。复发定义为临床症状复发、CRP水平高于参考范围或缓解后两者同时出现。使用单变量和多变量Cox模型评估缓解至复发时间的相关性。

结果

119只犬中,114只(95.8%)实现缓解。在85只具有复发数据的犬中,复发的中位时间为6.5个月,6个月时复发率为43%,12个月时为61%,24个月时为65%。在多变量分析中,初次入院时血小板增多症(调整后风险比[aHR]=5.5[2.0-15.0],p<0.001)、淋巴结肿大(aHR=4.0[1.5-11],p=0.006)和跛行(aHR=3.9[1.2-12.2],p=0.02)与缓解至复发时间独立且显著相关。

结论

本研究强调了非关联性IMPA犬的临床结果良好,缓解率高,但复发风险大。跛行、淋巴结肿大和血小板增多症与更高的复发风险相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e44/12412138/964d24180311/JVIM-39-e70241-g002.jpg

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