经过对类风湿性关节炎进行甲索特雷克萨治疗后,淋巴增殖性疾病的风险
Keisuke Tanaka1, Ayako Ichikawa1, Natsuka Umezawa2
1Department of Hematology, Tokyo Medical and Dental University, Tokyo, Japan.
Cancer science
|June 27, 2023
概括
甲索特雷克萨 (MTX) 相关的淋巴增殖障碍 (MTX-LPD) 影响了超过10年的20名类风湿性关节炎患者中约1名,但不会影响存活率. 塔克罗利马斯的使用会增加一些患者的MTX-LPD风险.
科学领域:
- 类风湿病学 类风湿病学
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 甲托雷克萨特 (MTX) 是一种常见的类风湿性关节炎 (RA) 治疗方法.
- 与MTX相关的淋巴增殖障碍 (MTX-LPD) 是已知的并发症,但其发生率,预后和风险因素需要进一步澄清.
- 了解这些方面对于管理MTX治疗的RA患者至关重要.
研究的目的:
- 确定RA患者中MTX-LPD的实际发病率.
- 调查MTX-LPD对患者存活时间的预后影响.
- 确定与MTX-LPD发展相关的风险因素.
主要方法:
- 这是一项回顾性研究,分析了使用MTX治疗的986名RA患者的数据.
- 评估新的恶性瘤 (NMs),特别关注LPD.
- 分析累积发病率,存活率和同时服用药物的影响.
主要成果:
- 累计的MTX-LPD发病率为1.3%在5年和4.7%在10年.
- 停止MTX导致24名LPD患者中15名患者的持续回归.
- 在患有LPD和没有新恶性瘤的患者之间,整体存活率没有显著差异. 塔克罗利斯增加了LPD风险,特别是在不服用bDMARDs的患者中.
结论:
- 大约在20名RA患者中,有1名在10年的MTX治疗中发展到MTX-LPD,但它不会对存活率产生不利影响.
- 红细胞沉积率持续上升可能表明LPD的发展.
- 在接受MTX治疗的RA患者中,应谨慎使用塔克罗利木斯,因为LPD的风险增加.
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