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甲索和类风湿性关节炎患者的死亡率:一项前性研究
Hyon K Choi1, Miguel A Hernán, John D Seeger
1Arthritis Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Harvard School of Public Health, Boston, MA, USA.
Lancet (London, England)
|April 17, 2002
概括
甲托雷克萨特显著降低了类风湿性关节炎患者的死亡率,主要是通过降低心血管疾病死亡率. 这一发现确立了甲状腺素作为评估新的类风湿性关节炎治疗方法的基准.
科学领域:
- 类风湿病学 类风湿病学
- 临床流行病学 临床流行病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 甲托雷克萨特是一种主要的疾病修饰性抗风湿药物,用于类风湿性关节炎.
- 之前的研究证实了它对发病率的有效性,但对死亡率的影响尚不清楚.
- 这项研究旨在前性评估甲状腺素对类风湿性关节炎患者死亡率的影响.
研究的目的:
- 评估甲状腺素对类风湿性关节炎患者死亡率的影响.
- 为了确定甲状腺素使用是否会影响整体生存率.
- 为了比较甲状腺素对死亡率的影响与其他修饰疾病的抗风湿药物.
主要方法:
- 研究了一组1240名类风湿性关节炎患者的队列.
- 包括人口统计,临床,实验室和自我报告信息在内的数据被前性地收集.
- 一个边际结构的考克斯比例危险模型被用来估计甲状腺素的死亡危险比率.
主要成果:
- 在随访期间发生了191例死亡.
- 甲托雷克萨特使用者 (n=588) 最初的预后因素较差.
- 调整后的分析显示,甲铁使用的死亡风险比为0.4 (95% CI 0.2-0.8),表明死亡率降低,特别是心血管死亡 (HR 0.3).
结论:
- 甲托雷克萨特的使用与类风湿性关节炎患者的显著生存益处有关.
- 这种好处似乎在很大程度上是由心血管死亡率降低所驱动的.
- 甲索的生存益处作为未来类风湿性关节炎治疗的基准.
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