Abstract | Cilj istraživanja: Ciljevi istraživanja bili su ispitati postojanje rizičnih čimbenika za razvoj seronegativnog spondiloartritisa i njihovu povezanost s ishodom, ispitati povezanost tijeka bolesti s ishodom i vrstom terapije te povezanost komorbiditeta s ishodom bolesti. Ustroj studije: presječna studija Ispitanici i metode: U istraživanju je sudjelovalo 150 pacijenata sa seronegativnim spondiloartritisom dijagnosticiranih i praćenih na Zavodu za reumatologiju, kliničku imunologiju i alergologiju KBC-a Osijek. Klinički podatci prikupljeni su iz povijesti bolesti. Zabilježeni su dob, spol, osnovna bolest, godina postavljanja dijagnoze, prvi simptomi, HLA-B27 i ostali lokusi, laboratorijski pokazatelji, postojanje radioloških promjena, komorbiditeti, postojanje sakroileitisa i/ili perifernog artritisa, dijagnoza psorijaze kao poseban entitet, godina dijagnoze psorijaze, vrsta terapije, doza glukokortikoidne terapije te indeksi vrijednosti BASFI, ASDAS i BASDAI. Rezultati: Kod žena značajno više prisutni su enteropatski spondiloartritis i nediferencirani spondiloartritis, kod muškaraca ankilozantni spondilitis, dok psorijatični artritis ne pokazuje spolnu predominaciju. Pacijenti s AS-om dominantno su HLA-B27 pozitivni, dok su pacijenti sa PsA-om i SpA-om pokazali slabiju korelaciju. Uz HLA-B27 prisutni su HLA-DRB1*01, HLA-B35 te HLA-DQB1*03. Nismo pronašli povezanost tijeka bolesti s ishodom bolesti ni vrstom terapije. Najčešći komorbiditeti bili su: hipertenzija, gastrointestinalne bolesti, metaboličke i psihijatrijske bolesti. Više od polovice pacijenata prima konvencionalnu terapiju, AS pacijenti češće primaju biološku terapiju, a SpA rjeđe. Vrijednosti BASFI-a, BASDAI-a i ASDAS-a smanjile su se nakon uvođenja biološke terapije, što pokazuje dobar ishod bolesti. Zaključak: Spol, dob i HLA-B27 predstavljaju rizične čimbenike za seronegativne spondiloartritise, a ishodi i kontrola aktivnosti bolesti povoljni su u liječenih pacijenata. |
Abstract (english) | Objectives: The study aimed to examine the existence of risk factors for the development of seronegative spondyloarthropathies, their correlation with the disease outcomes, the correlation between the course of the disease, outcomes and types of therapy as well as the correlation of underlying comorbidities with the disease outcome. Study Design: cross-sectional study Participants and Methods: The research included 150 patients with seronegative spondyloarthropathies diagnosed and monitored at the Institute for Rheumatology, Clinical Immunology and Alergology at Clinical Hospital Center Osijek. Clinical data were collected from medical history. The following patients data were collected and observed: age, sex, primary disease, year of diagnosis, initial symptoms, HLA-B27 and other loci, laboratory findings, radiographic changes, comorbidities, sacroileitis and/or peripheral arthritis, psoriasis and year of diagnosis, type of therapy, dose of glucocorticoid therapy, BASFI, ASDAS and BASDAI. Results: Enteropathic and undifferentiated spondyloarthritis were more common among women, while ankylosing spondylitis was more common in men. There was no statistically significant difference in sex in patients with psoriatic arthritis. Patients with AS are predominantly HLA-B27 positive, while PsA and SpA patients indicate a weaker correlation with HLA-B27. HLA-DRB1*01, HLA-B35 and HLA-DQB1*03 were the other commonly present loci. The research did not find the correlation of the disease course and outcomes with the types of therapy. The most common comorbidities included: hypertension, gastrointestinal, metabolic diseases, and psychiatric diseases. More than half patients received non-biological conventional therapy; patients with AS more commonly received biological therapy, unlike patients with SpA. BASFI, BASDAI and ASDAS values decreased, showing a positive disease outcome. Conclusion: Sex, age and HLA-B27 are the risk factors in seronegative spondyloarthritis. The disease outcomes are favorable and well controlled in observed treated patients. |