J Rheumatol:强直性脊柱炎患者椎体骨折的风险和后果

2020-03-01 xiangting MedSci原创

在开始TNFi治疗后,AS患者的VF风险显著升高并未被改变。尽管AS患者首次出现VF的年龄小于对照组,但这并不会导致死亡风险升高。

这项研究旨在比较强直性脊柱炎(AS)患者与匹配对照组椎体骨折(VF)的长期患病率、发病率和结局,包括关节外表现(EAM)和骨质疏松的影响。

研究人员使用1980-2015年就诊的2,321AS患者和22,976名对照的联网健康数据进行了一项全州范围的观察性研究。使用发病率(每1000人年)和比率(IRR)、多因素Cox比例风险回归和Kaplan-Meier生存曲线进行数据分析。

中位随访13.92年(IQR 7.5821.67)期间,AS患者的VF患病率和出现新VF的发病率均高于对照组(分别为9.3vs 2.5%、6.8vs 1.9%,p均<0.001)。与对照组相比,调整年龄、性别和骨质疏松症后,AS患者发生VF的风险升高(HR = 2.55 95CI2.113.09),并且在整个研究期间一直如此。与相应对照组相比,AS患者首次出现VF的年龄小5岁(p=0.008),并且再次发生VF的可能性更大(IRR=4.64; 95CI4.544.75)。调整年龄、性别、骨质疏松症和VF状态后,AS患者与对照组的总死亡率相当(HR=0.90 95CI0.801.01)。

开始TNFi治疗后,AS患者的VF风险显著升高并未被改变。尽管AS患者首次出现VF的年龄小于对照组,但这并不会导致死亡风险升高。

原始出处:

Milica Ognjenovic. The risk and consequences of vertebral fracture in patients with Ankylosing Spondylitis: a population-based data linkage study. J Rheumatol. February 2020.

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    2020-09-19 zywlvao
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    2020-03-03 dingxiaobo
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