甲氨蝶呤治疗银屑病患者早期预防银屑病关节炎-一项回顾性队列研究。

IF 3.8 3区 医学 Q1 RHEUMATOLOGY Joint Bone Spine Pub Date : 2024-12-21 DOI:10.1016/j.jbspin.2024.105833
Danielle Bar , Merav Lidar , Sharon Baum , Aviv Barzilai , Felix Pavlotsky , Amit Druyan
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引用次数: 0

摘要

目的:探索银屑病的早期生物治疗以预防或延迟银屑病关节炎(PsA)的发作。这重新引起了人们对甲氨蝶呤(MTX)在减轻新诊断的银屑病患者PsA风险方面的潜在作用的兴趣。本研究的目的是评估早期MTX治疗对牛皮癣患者PsA发病率的影响。方法:对2014 - 2024年在某三级医疗中心治疗的银屑病患者进行回顾性、纵向队列研究。患者分为早期MTX治疗组(发病2年内开始MTX治疗)、晚期MTX治疗组(发病2年后开始MTX治疗)和对照组(未使用dmard治疗)。PsA发病率计算为每100例患者年发生的事件,并使用时间相关的Cox比例风险模型来比较各组之间的PsA风险。进行敏感性分析以验证结果。结果:629例患者被随访,平均13.03年,累计8498.5人年。总体PsA风险为3.51事件/ 100患者年。早期MTX组的PsA发生率(1.07事件/100患者年)显著低于对照组(4.45事件/100患者年,调整后HR: 0.24)。结论:中重度银屑病患者早期开始使用甲氨蝶呤可降低PsA的发生风险。
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Early methotrexate treatment for psoriatic arthritis prevention in psoriasis patients – A retrospective cohort study

Objectives

Early initiation of biologic therapies for psoriasis has been explored to prevent or delay the onset of psoriatic arthritis (PsA). This has renewed interest in the potential role of methotrexate (MTX) in mitigating PsA risk in newly diagnosed psoriasis patients. The aim of this study was to evaluate the impact of early MTX initiation on PsA incidence in individuals with psoriasis.

Methods

A retrospective, longitudinal cohort study of psoriasis patients treated at a tertiary center from 2014 to 2024 was conducted. Patients were categorized into early MTX (MTX initiation within 2 years of psoriasis onset), late MTX (> 2 years after onset), and a control group (non-DMARD treatment). PsA incidence was calculated as events per 100 patient years, and a time-dependent Cox proportional hazard model was used to compare PsA risk across groups. Sensitivity analyses were performed to validate results.

Results

A total of 629 patients were followed for a mean of 13.03 years, accumulating 8498.5 person-years. The overall PsA risk was 3.51 events per 100 patient years. The early MTX group had a significantly lower PsA incidence (1.07 events/100 patient years) compared to both the control (4.45 events/100 patient years, adjusted HR: 0.24, P < 0.001) and late MTX groups (2.66 events/100 patient years, adjusted HR: 0.36, P < 0.01). This effect persisted in patients naïve to biologics and with a minimum follow-up of 10 years.

Conclusions

Early initiation of methotrexate in patients with moderate to severe psoriasis may reduce the risk of developing PsA.
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来源期刊
Joint Bone Spine
Joint Bone Spine 医学-风湿病学
CiteScore
4.50
自引率
11.90%
发文量
184
审稿时长
25 days
期刊介绍: Bimonthly e-only international journal, Joint Bone Spine publishes in English original research articles and all the latest advances that deal with disorders affecting the joints, bones, and spine and, more generally, the entire field of rheumatology. All submitted manuscripts to the journal are subjected to rigorous peer review by international experts: under no circumstances does the journal guarantee publication before the editorial board makes its final decision. (Surgical techniques and work focusing specifically on orthopedic surgery are not within the scope of the journal.)Joint Bone Spine is indexed in the main international databases and is accessible worldwide through the ScienceDirect and ClinicalKey platforms.
期刊最新文献
Contents Editorial Board Associations of the ALDH2 rs671 polymorphism and alcohol intake with early-onset gout in a Chinese male cohort. Clinical and ultrasonographic predictors of disease activity after TNF-α inhibitor spacing in patients with psoriatic arthritis. Could the anti-modified protein antibody concept help better define seronegative rheumatoid arthritis?
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