Is there a reduction in hip destruction under a treat-to-target strategy in patients with rheumatoid arthritis?
Is there a reduction in hip destruction under a treat-to-target strategy in patients with rheumatoid arthritis?
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类风湿关节炎患者的靶向治疗策略是否会减少髋关节破坏？
DOI：
10.1093/mr/road021
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发表时间：
2023
影响因子：
2.2
通讯作者：
Nakashima Yasuharu
中科院分区：
文献类型：
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作者：
Tsushima Hidetoshi;Takahide Sakuragi;Akasaki Yukio;Fujiwara Toshifumi;Hara Daisuke;Ikemura Satoshi;Sakuraba Kouji;Kamura Satoshi;Miyahara Hisaaki;Yamada Hisakata;Fukushi Jun-ichi;Nakashima Yasuharu
目的类风湿性关节炎（RA）的治疗方法有了很大的改进，对疾病活动性的严格控制产生了上级临床结果。本研究的目的是阐明伴随的变化，髋关节破坏后实施的治疗目标的策略，为患者RA。MethodsWe提取了190髋关节在两个时期，即早期（1998-2003年）和晚期（2013-19年），103和87髋关节，分别。对初次全髋关节置换术前的风湿性改变（如向内移位、向上移位和股骨头塌陷）和骨关节炎性改变（如形成一个资本下降）进行了定量评价。在晚期组中，上移（-3.44 vs.-7.45 mm;P< .001）和上移（+4.3 vs. +0.95 mm;P< .001）显著减少。股骨头塌陷无显著差异。资本下降的发生率显着较高的后期组（7.8%比27.5%;P<0.001）。ConclusionsThe程度向内和向上迁移的风湿性变化的代表减少，而资本下降的频率骨关节炎的变化增加在后期。
ObjectivesThe treatments for rheumatoid arthritis (RA) have been greatly improved, and the tight control of disease activity yields superior clinical outcomes. This study aimed to elucidate the accompanying changes in hip destruction following the implementation of a treat-to-target strategy for patients with RA.MethodsWe extracted 190 hips over two periods, i.e. the early period (1998–2003) and the late period (2013–19), with 103 and 87 hips, respectively. The observed rheumatic changes, such as inward migration, upward migration, and femoral head collapse, were quantitatively evaluated, while osteoarthritic changes, such as the formation of a capital drop, were investigated from radiographs before primary total hip arthroplasty.ResultsA comparison of the two periods’ data showed that the degree of inward migration (−3.44 vs. −7.45 mm;P< .001) and upward migration (+4.3 vs. +0.95 mm;P< .001) significantly decreased in the late-period group. The collapse of the femoral head was not significantly different. The incidence of capital drops was significantly higher in the late-period group (7.8% vs. 27.5%;P< .001).ConclusionsThe degree of inward and upward migration representative of rheumatic changes reduced, whereas the frequency of capital drops as osteoarthritic changes increased during the late period.