Arthritis Rheumatol:治疗对中轴型脊柱关节炎放射学进展的影响

2020-02-23 xiangting MedSci原创

尽管在2年和≥4年时未观察到TNFi治疗对AS脊柱放射学进展有明显的保护作用,但仅限于低偏倚风险的研究分析显示,在≥4年时TNFi治疗有保护作用。

这项研究旨在探讨治疗对中轴型脊椎关节炎(axSpA)放射学进展的影响。

研究人员进行全面的数据库检索,以查找评估axSpA放射学进展的研究(特定治疗vs.无特定治疗)。估算研究特异性标化平均差,并使用随机效应模型进行组合。

纳入24项研究。其中使用肿瘤坏死因子抑制剂(TNFi)治疗18项,非甾体抗炎药(NSAIDs8项,苏金单抗1项。2年时(mSASSS差异=-0.7395CI -1.520.12I2 = 28%)和≥4年时(mSASSS差异=-2.0395CI -4.630.72I2 = 63%),TNFi治疗组与生物制剂初治人群的脊柱放射学进展无明显差异。仅限于低偏倚风险研究的敏感性分析显示,在≥4年时有显著差异(mSASSS差异=-2.1795CI -4.19-0.15)。NSAIDs vs.对照组(mSASSS差异=-0.3095CI = -2.621.31I2= 71%)或苏金单抗vs. 生物制剂初治组未观察到显著差异(mSASSS差异=-0.3495CI-0.850.17)。没有足够的nr-axSpASIJ进展研究用于分析。

尽管在2年和≥4年时未观察到TNFi治疗对AS脊柱放射学进展有明显的保护作用,但仅限于低偏倚风险的研究分析显示,在≥4年时TNFi治疗有保护作用。因此,长期TNFi治疗可能对影像学进展有益。在2年时,NSAIDs或苏金单抗没有差异。未来的研究应当探讨生物制剂对早期axSpAnr-axSpA放射学进展,以及长期暴露的影响。

原始出处:

Paras Karmacharya. The Effect of Therapy on Radiographic Progression in Axial Spondyloarthritis: A Systematic Review and Meta‐Analysis. Arthritis Rheumatol. January 2020.

本文系梅斯医学(MedSci)原创编译整理,转载需授权!

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1972700, encodeId=df5619e2700db, content=<a href='/topic/show?id=8a6a2e8839' target=_blank style='color:#2F92EE;'>#Arthritis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, 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=Thu May 21 16:12:00 CST 2020, time=2020-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266112, encodeId=cfce1266112a0, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Tue Feb 25 05:12:00 CST 2020, time=2020-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1318713, encodeId=51e91318e1393, content=<a href='/topic/show?id=6b4a845138d' target=_blank style='color:#2F92EE;'>#脊柱关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84513, encryptionId=6b4a845138d, topicName=脊柱关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bcd469, createdName=fengting3, createdTime=Tue Feb 25 05:12:00 CST 2020, time=2020-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357402, encodeId=b449135e40247, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Feb 25 05:12:00 CST 2020, time=2020-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385638, encodeId=c0fe138563892, content=<a href='/topic/show?id=b3d05e3382b' target=_blank style='color:#2F92EE;'>#放射学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57338, encryptionId=b3d05e3382b, topicName=放射学)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e3bb506, createdName=kkunny, createdTime=Tue Feb 25 05:12:00 CST 2020, time=2020-02-25, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1972700, encodeId=df5619e2700db, content=<a href='/topic/show?id=8a6a2e8839' target=_blank style='color:#2F92EE;'>#Arthritis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, 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=Thu May 21 16:12:00 CST 2020, time=2020-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266112, encodeId=cfce1266112a0, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Tue Feb 25 05:12:00 CST 2020, time=2020-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1318713, encodeId=51e91318e1393, content=<a href='/topic/show?id=6b4a845138d' target=_blank style='color:#2F92EE;'>#脊柱关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84513, encryptionId=6b4a845138d, topicName=脊柱关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bcd469, createdName=fengting3, createdTime=Tue Feb 25 05:12:00 CST 2020, time=2020-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357402, encodeId=b449135e40247, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Feb 25 05:12:00 CST 2020, time=2020-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385638, encodeId=c0fe138563892, content=<a href='/topic/show?id=b3d05e3382b' target=_blank style='color:#2F92EE;'>#放射学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57338, encryptionId=b3d05e3382b, topicName=放射学)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e3bb506, createdName=kkunny, createdTime=Tue Feb 25 05:12:00 CST 2020, time=2020-02-25, status=1, ipAttribution=)]
    2020-02-25 lmm397
  3. [GetPortalCommentsPageByObjectIdResponse(id=1972700, encodeId=df5619e2700db, content=<a href='/topic/show?id=8a6a2e8839' target=_blank style='color:#2F92EE;'>#Arthritis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, 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=Thu May 21 16:12:00 CST 2020, time=2020-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266112, encodeId=cfce1266112a0, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Tue Feb 25 05:12:00 CST 2020, time=2020-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1318713, encodeId=51e91318e1393, content=<a href='/topic/show?id=6b4a845138d' target=_blank style='color:#2F92EE;'>#脊柱关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84513, encryptionId=6b4a845138d, topicName=脊柱关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bcd469, createdName=fengting3, createdTime=Tue Feb 25 05:12:00 CST 2020, time=2020-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357402, encodeId=b449135e40247, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Feb 25 05:12:00 CST 2020, time=2020-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385638, encodeId=c0fe138563892, content=<a href='/topic/show?id=b3d05e3382b' target=_blank style='color:#2F92EE;'>#放射学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57338, encryptionId=b3d05e3382b, topicName=放射学)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e3bb506, createdName=kkunny, createdTime=Tue Feb 25 05:12:00 CST 2020, time=2020-02-25, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1972700, encodeId=df5619e2700db, content=<a href='/topic/show?id=8a6a2e8839' target=_blank style='color:#2F92EE;'>#Arthritis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, 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=Thu May 21 16:12:00 CST 2020, time=2020-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266112, encodeId=cfce1266112a0, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Tue Feb 25 05:12:00 CST 2020, time=2020-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1318713, encodeId=51e91318e1393, content=<a href='/topic/show?id=6b4a845138d' target=_blank style='color:#2F92EE;'>#脊柱关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84513, encryptionId=6b4a845138d, topicName=脊柱关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bcd469, createdName=fengting3, createdTime=Tue Feb 25 05:12:00 CST 2020, time=2020-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357402, encodeId=b449135e40247, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Feb 25 05:12:00 CST 2020, time=2020-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385638, encodeId=c0fe138563892, content=<a href='/topic/show?id=b3d05e3382b' target=_blank style='color:#2F92EE;'>#放射学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57338, encryptionId=b3d05e3382b, topicName=放射学)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e3bb506, createdName=kkunny, createdTime=Tue Feb 25 05:12:00 CST 2020, time=2020-02-25, status=1, ipAttribution=)]
    2020-02-25 zhaojie88
  5. [GetPortalCommentsPageByObjectIdResponse(id=1972700, encodeId=df5619e2700db, content=<a href='/topic/show?id=8a6a2e8839' target=_blank style='color:#2F92EE;'>#Arthritis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, 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=Thu May 21 16:12:00 CST 2020, time=2020-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266112, encodeId=cfce1266112a0, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Tue Feb 25 05:12:00 CST 2020, time=2020-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1318713, encodeId=51e91318e1393, content=<a href='/topic/show?id=6b4a845138d' target=_blank style='color:#2F92EE;'>#脊柱关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84513, encryptionId=6b4a845138d, topicName=脊柱关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bcd469, createdName=fengting3, createdTime=Tue Feb 25 05:12:00 CST 2020, time=2020-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357402, encodeId=b449135e40247, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Feb 25 05:12:00 CST 2020, time=2020-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385638, encodeId=c0fe138563892, content=<a href='/topic/show?id=b3d05e3382b' target=_blank style='color:#2F92EE;'>#放射学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57338, encryptionId=b3d05e3382b, topicName=放射学)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e3bb506, createdName=kkunny, createdTime=Tue Feb 25 05:12:00 CST 2020, time=2020-02-25, status=1, ipAttribution=)]
    2020-02-25 kkunny

相关资讯

Arthritis Rheumatol:区分中轴型脊柱关节炎与其他原因臀部/骨盆疼痛的骶髂关节MRI病变

BME和脂肪病变在axSpA中最为明显,但也发生在其他组,特别是产后疼痛的女性。

Ann Rheum Dis:45岁以下人群中,提示脊柱中轴型脊柱关节炎MRI改变的发生率

这项基于人群的大型研究发现,提示axSpA的炎症和脂肪MRI病变的发生率很高,尤其是脊柱。这表明这种MRI表现对于axSpA的诊断和分类的价值有限。

2019 台湾临床实践建议:影像学检查在中轴型脊柱关节炎的诊断和管理中的应用

中轴型脊柱关节炎(axSpA)是一种慢性炎症性疾病,其早期诊断充满挑战,为改善axSpA的临床诊断和管理,依据当前axSpA分类标准和影像学检查的最新进展制定了该临床实践建议。

Ann Rheum Dis:TNFi初始治疗中轴型脊柱关节炎患者的治疗反应和药物保留率

27%的患者在6个月后达到ASDAS非活动性疾病,而59%达到BASDAI<40。5名患者中有4名在1年后继续治疗。

J Rheumatol:中轴型脊柱关节炎对心理健康的影响

axSpA患者的精神障碍患病率很高。结合特定的社会人口学特征,疾病活动性高是精神障碍风险的良好指标。

中轴型脊柱关节炎诊断和治疗的专家共识(2019年版)

SpA 的早期症状主要表现为炎性腰背痛,患者会至骨科、风湿科、疼痛科、康复科、中医科等各临床科室门诊就诊。由于缺乏对SpA 诊断和治疗的认识,以致该疾病常被漏诊、误诊或延迟诊断,使得许多患者错失SpA 治疗的最佳时间,导致患者的病情和残疾程度加重。本次共识旨在规范SpA 在临床工作中的诊断和治疗,为临床相关人员提供该疾病诊断和治疗的依据。在临床工作中,中轴型脊柱关节炎(axial SpA,ax-S