Semin Arthritis Rheu:男性强直性脊柱炎患者TNF-α抑制剂治疗期间的影像学进展多于女性

2018-08-11 xiangting MedSci原创

男性和女性患者在TNF-α抑制剂治疗期间的临床改善相当。然而,2年后男性患者的影像学脊柱损伤更为明显。

强直性脊柱炎(AS)的临床表现因性别而异。这项研究目的是探讨日常临床实践中肿瘤坏死因子(TNF)-α抑制剂治疗开始前后男性和女性AS患者疾病活动性、疾病预后和治疗反应的差异。

研究纳入Groningen Leeuwarden AS(GLAS)队列中开始TNF-α抑制剂治疗的患者,这些患者在基线和3个月后和/或2年后进行了随访。

在纳入的254名AS患者中,69%是男性。基线时,女性患者的BASDAI、ASDAS和触痛附着点炎评分显著高于男性患者。与之相反,男女患者的CRP、肿胀关节和关节外表现病史相当。女性的身体功能和生活质量明显较差,而男性则有更多的脊柱后凸和脊柱影像学损伤。3个月和2年的随访后,所有的临床评估均有显著改善,女性和男性患者的平均变化评分相当;分别为BASDAI平均2年变化 -2.7 vs.-2.7,ASDAS -1.50 vs.-1.68,触痛附着点炎 -2.4 vs.-1.4,CRP -8 vs.-8,BASFI -2.2 vs.-2.1和ASQoL -5 vs.-4。男性患者的影像学进展更明显。在2年的随访期间,更多的女性患者换为其他TNF-α抑制剂治疗(32%vs.14%)。

尽管女性患者疾病活动性更高、身体功能和生活质量更差,更频繁地转换TNF-α抑制剂,但是男性和女性患者在TNF-α抑制剂治疗期间的临床改善相当。然而,2年后男性患者的影像学脊柱损伤更为明显。

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    2018-09-28 zywlvao
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    2018-09-18 jklm09
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topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Tue Sep 18 18:20:00 CST 2018, time=2018-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1972519, encodeId=e23619e25196c, content=<a href='/topic/show?id=8a6a2e8839' target=_blank style='color:#2F92EE;'>#Arthritis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2788, encryptionId=8a6a2e8839, topicName=Arthritis)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIibticIBly5jCSic5ZElW4He3rO4DMpUHUFaFX57OicNMnzckWaicBNeStwugWHFCuOdicoakApM4HGmtw/132, createdBy=f8672500006, createdName=ms6390871039024434, createdTime=Tue Feb 12 06:20:00 CST 2019, time=2019-02-12, status=1, ipAttribution=), 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  5. 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objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84542, encryptionId=6f0e845427f, topicName=脊柱炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=50834728424, createdName=1249898am16暂无昵称, createdTime=Mon Aug 13 02:20:00 CST 2018, time=2018-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1495827, encodeId=6bc2149582e3f, content=<a href='/topic/show?id=9df21e5833d' target=_blank style='color:#2F92EE;'>#TNF-α抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17583, encryptionId=9df21e5833d, topicName=TNF-α抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4fcb9213199, createdName=DEXTER3142, createdTime=Mon Aug 13 02:20:00 CST 2018, time=2018-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337929, encodeId=354a33e929b8, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Sat Aug 11 15:03:39 CST 2018, time=2018-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337908, encodeId=31af33e90893, content=学习了,涨知识了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Sat Aug 11 13:48:42 CST 2018, time=2018-08-11, status=1, ipAttribution=)]
    2018-08-13 zhaojie88
  6. 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encodeId=354a33e929b8, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Sat Aug 11 15:03:39 CST 2018, time=2018-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337908, encodeId=31af33e90893, content=学习了,涨知识了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Sat Aug 11 13:48:42 CST 2018, time=2018-08-11, status=1, ipAttribution=)]
    2018-08-13 snowpeakxu
  7. 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    2018-08-11 医者仁心5538

    学习了

    0

  10. 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    2018-08-11 王秀

    学习了,涨知识了!

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