中轴型脊柱关节炎患者的病程越长，发生急性前葡萄膜炎或炎性肠病风险越高

作者：Varkas G，et al.

翻译：北医三院李常虹

摘要：目的：在两个不同招募时间段内独立的大型全国中轴型脊柱关节炎（AxSpA）研究队列中，明确关节外表现与患者基线特征之间的关系，同时评估其潜在的不同的预后价值。

方法：分析用的资料来源于两个队列研究，一个是自2010年以来连续入组的中轴型脊柱关节炎患者，1个是2004年2月至2005年间连续入组的强直性脊柱炎或可能诊断为强直性脊柱炎的患者。

结果：在1250例比利时的中轴型脊柱关节炎患者中，仅急性前葡萄膜炎和炎症性肠病与疾病病程相关，每10年病程，增加的风险分别为20%和30%。在171例新近确诊且进行后续随访的亚组患者中，伴有急性前葡萄膜炎或炎症性肠病的患者较不伴有这两种关节外表现的患者有长期更高的CRP水平。

结论：中轴型脊柱关节炎患者的病程越长，发生急性前葡萄膜炎或炎性肠病（而非银屑病）风险越高，且急性前葡萄膜炎或炎性肠病者的炎症程度更高，可能预示不同的结构性进展。

附原文：Abstract OBJECTIVE: To determine the link between extra-articular manifestations (EAMs) and baseline patient characteristics, and to define their potentially differential prognostic value in two large nation-wide and independent AxSpA cohorts with distinct recruitment periods.METHODS: The analyzed data originate from the (Be-)Giant cohort which includes consecutive patients with AxSpA since 2010, whereas ASPECT which includes information on consecutive patients with ankylosing spondylitis (AS) and probable AS between February 2004 and 2005.RESULTS: In 1250 Belgian AxSpA patients, only acute anterior uveitis and inflammatory bowel disease were associated with disease duration, with an increase of the risk by 20% (RR 1.2, p<0.001) and="" 30%="" (rr="" 1.3,="" p="0.026)" respectively,="" per="" 10="" years="" of="" disease="" duration.="" in="" a="" subgroup="" of="" 171="" newly="" diagnosed="" patients="" with="" prospective="" follow-up,="" higher="" mean="" crp="" levels="" over="" time="" were="" demonstrated="" in="" patients="" with="" aau="" or="" ibd="" versus="" those="" without="" eams="" or="" psoriasis="" alone="" (p="0.01).CONCLUSIONS:" the="" risk="" of="" developing="" acute="" anterior="" uveitis="" or="" inflammatory="" bowel="" disease,="" but="" not="" psoriasis,="" seems="" to="" increase="" with="" disease="" duration="" in="" axspa="" and="" appears="" to="" be="" linked="" to="" a="" higher="" cumulative="" exposure="" to="" inflammation,="" possibly="" explaining="" differential="" structural="">

引自：Varkas G, Vastesaeger N, Cypers H, Colman R, Renson T, Van Praet L, Carron P, Raeman F, Devinck M, Gyselbrecht L, Corluy L, Piette Y, Lenaerts J, Thevissen K, Vanneuville B, Van den Bosch F, ElewautD.Inflammatory bowel disease and acute anterior uveitis, but not psoriasis are associated with disease duration in Axial SpA: results from the (Be)Giant and ASPECT cohort.Arthritis Rheumatol. 2018 May 9. doi: 10.1002/art.40551. [Epub ahead of print]