Women, men, and rheumatoid arthritis: analyses of disease activity, disease characteristics, and treatments in the QUEST-RA study.
Women, men, and rheumatoid arthritis: analyses of disease activity, disease characteristics, and treatments in the QUEST-RA study.
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DOI：
10.1186/ar2591
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发表时间：
2009
影响因子：
4.9
通讯作者：
QUEST-RA Group
中科院分区：
文献类型：
--
作者：
Sokka T;Toloza S;Cutolo M;Kautiainen H;Makinen H;Gogus F;Skakic V;Badsha H;Peets T;Baranauskaite A;Géher P;Ujfalussy I;Skopouli FN;Mavrommati M;Alten R;Pohl C;Sibilia J;Stancati A;Salaffi F;Romanowski W;Zarowny-Wierzbinska D;Henrohn D;Bresnihan B;Minnock P;Knudsen LS;Jacobs JW;Calvo-Alen J;Lazovskis J;Pinheiro Gda R;Karateev D;Andersone D;Rexhepi S;Yazici Y;Pincus T;QUEST-RA Group
几十年来，性别作为类风湿性关节炎（RA）结果的预测因素引起了人们极大的兴趣。从历史上看，对于 RA 在女性或男性中是否更严重，尚未达成共识。最近的报告表明，女性获得缓解的可能性低于男性。因此，我们的目的是在一个大型多国横断面 RA 患者队列中研究性别与疾病活动度、疾病特征和 RA 治疗之间可能的关联，称为 RA 患者定量标准监测 (QUEST-RA)。该队列包括接受常规护理的患者的临床和问卷数据，包括截至 2008 年 4 月 25 个国家 70 个地点的 6,004 名患者。对美国风湿病学会核心数据集的疾病活动、DAS28（使用 28 个关节计数的疾病活动评分）、疲劳、类风湿因子的存在、结节和糜烂以及目前使用泼尼松、甲氨蝶呤、和生物制剂。在所有核心数据集指标中，女性的得分均低于男性。女性和男性的平均值分别为肿胀关节计数 28 (SJC28) 为 4.5 与 3.8，压痛关节计数 28 为 6.9 与 5.4，红细胞沉降率为 30 与 26，健康评估问卷为 1.1 与 0.8，医生总体估计视觉模拟量表为 3.0 与 2.5，疼痛为 4.3 与3.6，患者总体状态为 4.2 与 3.7，DAS28 为 4.3 与 3.8，疲劳程度为 4.6 与 3.7（P < 0.001）。然而，SJC28 的效应大小为小至中等且最小 (0.13)。在 SJC28 上无疾病活动性或仅有轻微疾病活动性（0 至 1）的患者中，女性在所有其他疾病活动性指标中的平均值均显着高于男性（P < 0.001），并且达到 DAS28 缓解的频率低于男性。类风湿因子在性别中同样普遍。男性比女性更容易出现结节。女性比男性更容易出现糜烂，但统计意义微乎其微。接受不同疗法的女性和男性比例相似。在这个大型跨国队列中，女性的 RA 疾病活动度似乎比男性更差。然而，RA 疾病活动性的大部分性别差异可能源于疾病活动性的测量，而不是 RA 疾病活动性本身。
Gender as a predictor of outcomes of rheumatoid arthritis (RA) has evoked considerable interest over the decades. Historically, there is no consensus whether RA is worse in females or males. Recent reports suggest that females are less likely than males to achieve remission. Therefore, we aimed to study possible associations of gender and disease activity, disease characteristics, and treatments of RA in a large multinational cross-sectional cohort of patients with RA called Quantitative Standard Monitoring of Patients with RA (QUEST-RA). The cohort includes clinical and questionnaire data from patients who were seen in usual care, including 6,004 patients at 70 sites in 25 countries as of April 2008. Gender differences were analyzed for American College of Rheumatology Core Data Set measures of disease activity, DAS28 (disease activity score using 28 joint counts), fatigue, the presence of rheumatoid factor, nodules and erosions, and the current use of prednisone, methotrexate, and biologic agents. Women had poorer scores than men in all Core Data Set measures. The mean values for females and males were swollen joint count-28 (SJC28) of 4.5 versus 3.8, tender joint count-28 of 6.9 versus 5.4, erythrocyte sedimentation rate of 30 versus 26, Health Assessment Questionnaire of 1.1 versus 0.8, visual analog scales for physician global estimate of 3.0 versus 2.5, pain of 4.3 versus 3.6, patient global status of 4.2 versus 3.7, DAS28 of 4.3 versus 3.8, and fatigue of 4.6 versus 3.7 (P < 0.001). However, effect sizes were small-medium and smallest (0.13) for SJC28. Among patients who had no or minimal disease activity (0 to 1) on SJC28, women had statistically significantly higher mean values compared with men in all other disease activity measures (P < 0.001) and met DAS28 remission less often than men. Rheumatoid factor was equally prevalent among genders. Men had nodules more often than women. Women had erosions more often than men, but the statistical significance was marginal. Similar proportions of females and males were taking different therapies. In this large multinational cohort, RA disease activity measures appear to be worse in women than in men. However, most of the gender differences in RA disease activity may originate from the measures of disease activity rather than from RA disease activity itself.
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影响因子：
--
作者：
Jawaheer, Damini;Lum, Raymond F.;Criswell, Lindsey A.
通讯作者：
Criswell, Lindsey A.
影响因子：
5.5
作者：
Hyrich, K. L.;Watson, K. D.;Symmons, D. P. M.
通讯作者：
Symmons, D. P. M.
影响因子：
27.4
作者：
Burmester, Gerd R.;Mariette, Xavier;Kupper, Hartmut
通讯作者：
Kupper, Hartmut
DOI：
10.1093/pubmed/21.3.255
发表时间：
1999-09-01
期刊：
JOURNAL OF PUBLIC HEALTH MEDICINE
影响因子：
--
作者：
Bowling, A;Bond, M;Lamping, DL
通讯作者：
Lamping, DL
影响因子：
--
作者：
Krishnan, E;Sokka, T;Hannonen, P
通讯作者：
Hannonen, P