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J Rheumatol:类风湿性关节炎的性别相关治疗差异及其预后

2018-06-16 xiangting MedSci原创

这项全球性的观察研究表明在日常实践中,男性和女性RA患者采用不同的初始治疗,但治疗反应无性别差异。

这项研究旨在评估日常临床实践中,类风湿性关节炎(RA)男性和女性患者初始治疗和治疗反应的差异。

在这项国际性、观察性METEOR注册中,研究人员比较了开始不同抗风湿治疗(疾病改善抗风湿药物; DMARD)的RA患者比例和治疗反应。从开始首个DMARD到首个DMARD换药或随访结束的所有访问都被选中。使用Cox回归计算性别对从首次治疗转变为第二次治疗时间的影响。使用线性混合模型分析以评估是否男性和女性对治疗反应不同,治疗反应由疾病活动性评分(DAS)或健康评估问卷衡量。

女性(n=4393)开始治疗时更多使用羟氯喹作为单药治疗或与甲氨蝶呤(MTX)、糖皮质激素联合,而男性(n=1142)开始治疗时更多使用MTX和/或柳氮磺胺吡啶。女性DMARD换药的时间比男性短。随着时间的推移,女性的DAS在统计学上显著高于男性(每年的DAS改善 男性:β-0.69,95%CI为-0.75至-0.62;女性为-0.58,95%CI为-0.62至-0.55)。每个DMARD组的亚组分析显示,对于常规合成性DMARD联合治疗,与女性相比(-0.59,95%CI -0.67至-0.51),男性DAS随着时间推移降低稍多(-0.89,95%CI -1.07至-0.71)。但这些性别差异在临床上可以忽略不计。

这项全球性的观察研究表明在日常实践中,男性和女性RA患者采用不同的初始治疗,但治疗反应无性别差异。

原始出处:

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    2018-06-18 lmm397
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    2018-06-16 1dd8c52fm63(暂无匿称)

    了解了解.学习学习

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1265737, encodeId=9c621265e3780, 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=59, 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=Mon Jun 18 02:40:00 CST 2018, time=2018-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1334042, encodeId=6b1513340424a, content=<a href='/topic/show?id=5306e6164b6' target=_blank style='color:#2F92EE;'>#类风湿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76164, encryptionId=5306e6164b6, topicName=类风湿)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq2AGzrugK9ZUjU3eJxzM901ophWib0xJDrSicy49ibWl3zB5pbDto7eoR6tnzwOiaKdbq1a8PcbYFFrw/132, createdBy=6ff22500098, createdName=ms4964546379600229, createdTime=Mon Jun 18 02:40:00 CST 2018, time=2018-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483519, encodeId=3669148351973, content=<a href='/topic/show?id=55a6100826cc' target=_blank style='color:#2F92EE;'>#风湿性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100826, encryptionId=55a6100826cc, topicName=风湿性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c237911872, createdName=ms1467340776200723, createdTime=Mon Jun 18 02:40:00 CST 2018, time=2018-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324681, encodeId=44ae3246813d, content=了解了解.学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Sat Jun 16 15:19:36 CST 2018, time=2018-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324654, encodeId=6d3a3246545c, content=好文.值得点赞!认真学习了.把经验应用于实践.为患者解除病痛., beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=d85d1636106, createdName=lietome2, createdTime=Sat Jun 16 12:50:21 CST 2018, time=2018-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324648, encodeId=fe82324648e8, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sat Jun 16 12:18:40 CST 2018, time=2018-06-16, status=1, ipAttribution=)]
    2018-06-16 lietome2

    好文.值得点赞!认真学习了.把经验应用于实践.为患者解除病痛.

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1265737, encodeId=9c621265e3780, 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=59, 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=Mon Jun 18 02:40:00 CST 2018, time=2018-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1334042, encodeId=6b1513340424a, content=<a href='/topic/show?id=5306e6164b6' target=_blank style='color:#2F92EE;'>#类风湿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76164, encryptionId=5306e6164b6, topicName=类风湿)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq2AGzrugK9ZUjU3eJxzM901ophWib0xJDrSicy49ibWl3zB5pbDto7eoR6tnzwOiaKdbq1a8PcbYFFrw/132, createdBy=6ff22500098, createdName=ms4964546379600229, createdTime=Mon Jun 18 02:40:00 CST 2018, time=2018-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483519, encodeId=3669148351973, content=<a href='/topic/show?id=55a6100826cc' target=_blank style='color:#2F92EE;'>#风湿性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100826, encryptionId=55a6100826cc, topicName=风湿性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c237911872, createdName=ms1467340776200723, createdTime=Mon Jun 18 02:40:00 CST 2018, time=2018-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324681, encodeId=44ae3246813d, content=了解了解.学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Sat Jun 16 15:19:36 CST 2018, time=2018-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324654, encodeId=6d3a3246545c, content=好文.值得点赞!认真学习了.把经验应用于实践.为患者解除病痛., beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=d85d1636106, createdName=lietome2, createdTime=Sat Jun 16 12:50:21 CST 2018, time=2018-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324648, encodeId=fe82324648e8, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sat Jun 16 12:18:40 CST 2018, time=2018-06-16, status=1, ipAttribution=)]
    2018-06-16 惠映实验室

    学习了.谢谢分享.

    0

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