Öz
Amaç:
Bu çalışmada, Hacettepe Üniversitesi Romatoloji Biyolojik Veritabanı’nda (HUR-BIO) kayıtlı psöriyatik artrit (PsA) hastalarında obezitenin demografik ve klinik özelliklere, hastalık aktivite indekslerine ve biyolojik hastalık modifiye edici antiromatizmal ilaçların (bDMARD) ilaçta kalım oranlarına etkisinin değerlendirilmesi amaçlanmıştır.
Yöntem:
Çalışmaya HUR-BIO PsA veri tabanına kayıtlı hastalar dahil edildi. Şubat 2020’ye kadar HUR-BIO PsA veritabanında kayıtlı 469 hasta vardı. Vücut kitle indeksi ≥30 obezite olarak tanımlandı. Son analize yaş ve cinsiyet eşleştirilmiş 170 obez ve 170 obez olmayan PsA hastaları dahil edildi. Demografik, klinik, laboratuvar ve terapötik veriler bu veri tabanından toplanmıştır.
Sonuç:
Bazal hastalık aktivitesi ve fonksiyonları obez PsA grubunda obez olmayan gruba göre daha kötü olmasına rağmen, gruplar arasında tedavi yanıtlarında anlamlı bir fark yoktu. Obez PsA hastalarında, sınırda anlamlı olmamasına rağmen bDMARD’ların ilaç kalımı daha kötü görünmektedir. Obez PsA hastalarında kilo kaybı, inflamatuvar yükü, fonksiyonel parametreleri ve bDMARD’lerin ilaç kalımını pozitif yönde etkileyebilir.
Bulgular:
Obez grubun obez olmayan gruba göre psöriazis tanı yaşı istatistiksel anlamlı olarak daha yüksek ve PsA hastalık süresi daha kısa idi. İki grup arasında aksiyel tutulum, periferik tutulum (hastalık süresince), sigara kullanımı (hayatı boyunca),HLA-B27 pozitifliği, üveit ve inflamatuvar barsak hastalığı görülmesi, konvansiyonel sentetik hastalık modifiye edici antiromatizmal ilaç (csDMARD) ve steroid kullanımı, ilk ve son bDMARD’ların dağılımı açısından anlamlı bir fark bulunmazken diyabetes mellitus ve hipertansiyon obez grupta obez olmayan gruba göre anlamlı olarak daha yaygındı. bDMARD başlangıcında bazı hasta ölçekli sonlanım ölçütleri, obez grupta obez olmayan gruba göre anlamlı derecede daha yüksekti. Bununla birlikte, obez ve obez olmayan PsA hastalarının son vizitlerindeki hasta ölçekli sonlanım ölçütlerinde başlangıca göre değişiklik açısından ve anlamlı tedavi yanıtı açısından bir fark yoktu. İlk bDMARD’ların ilaçta kalım oranlarında PsA alt grupları arasında anlamlı bir fark olmamasına rağmen anlamlılık değerine çok yakındı (log-rank, p=0,055).
Anahtar Kelimeler: Psöriyatik artrit, obezite, bDMARD, sonuç ölçütleri, gerçek hayat, ilaçta kalım
Kaynakça
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