PsA patients who underwent HR-pQCT examination of the second to fourth metacarpophalangeal joint (MCPJ 2-4) were recruited in this cross-sectional study. The joint space metrics included joint space volume (JSV), mean, minimum, and maximum JSW, JSW asymmetry, and distribution. Correlation analysis and multivariable linear regression models were used to determine the association between disease-related variables and JSW.
Sixty-seven patients [37 (55.2%) males; median (IQR) age: 57.0 (53.0, 63.0); median disease duration: 21 (16, 28) years] were included in this analysis. Multivariable linear regression analysis demonstrated that males had larger JSV (MCPJ 2-4), mean (MCPJ 4), and maximum JSW (MCPJ 3). Longer disease duration (MCPJ 2-3) and higher ESR values (MCPJ 3) were negatively associated with mean and maximum JSW, while higher damage joint count was negatively associated with mean and minimum JSW (MCPJ 2). Use of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) was negatively associated with minimum JSW (MCPJ 3) while use of biologic DMARDs (bDMARDs) was positively associated with minimum JSW (MCPJ 2).
Higher inflammatory burden as reflected by longer disease duration, higher ESR levels, and damage joint count was negatively associated with mean, maximum, and minimum JSW, while suppression of inflammation using bDMARDs seems to limit the decline in JSW.
方法:本横断面研究招募了接受第二至第四掌指关节(MCPJ2-4)HR-pQCT检查的PsA患者。关节空间度量包括关节空间体积(JSV),意思是,minimum,和最大JSW,JSW不对称,和分配。使用相关性分析和多变量线性回归模型来确定疾病相关变量与JSW之间的关联。
结果:本分析纳入67例患者[男性37例(55.2%);中位(IQR)年龄:57.0(53.0,63.0);中位病程:21(16,28)年]。多变量线性回归分析表明,男性有较大的JSV(MCPJ2-4),平均值(MCPJ4),和最大JSW(MCPJ3)。较长的病程(MCPJ2-3)和较高的ESR值(MCPJ3)与平均和最大JSW呈负相关,而较高的损伤关节计数与平均和最小JSW(MCPJ2)负相关。使用常规合成的改善疾病的抗风湿药(csDMARDs)与最低JSW(MCPJ3)呈负相关,而使用生物DMARDs(bDMARDs)与最低JSW(MCPJ2)呈正相关。
结论:较长的病程反映了较高的炎症负担,ESR水平较高,损伤关节计数与平均值负相关,最大值,和最低JSW,而使用bDMARDs抑制炎症似乎限制了JSW的下降。