改变疾病的抗风湿药物与风湿性关节炎患者的不同糖尿病风险有关
Yu-Jih Su1,2,3, Hui-Ming Chen4, Tien-Ming Chan5
1Division of Rheumatology, Allergy, and Immunology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
RMD open
|July 17, 2023
概括
患有类风湿性关节炎 (RA) 的患者使用某些疾病修饰性抗风湿药物 (DMARD) 显示患糖尿病的风险降低. 生物DMARDs和组合疗法与较低的糖尿病发病率有关,而不是单独治疗甲醇.
科学领域:
- 类风湿病学 类风湿病学
- 内分泌学 在内分泌学.
- 临床药理学 临床药理学
背景情况:
- 风湿性关节炎 (RA) 患者面临糖尿病和心血管疾病的风险增加.
- 现有的RA治疗可能会影响糖尿病的发展,需要进一步调查.
- 了解治疗特异性糖尿病风险对于患者管理至关重要.
研究的目的:
- 评估不同疾病修饰性抗风湿药物 (DMARD) 疗法与RA患者新发糖尿病之间的关联.
- 为了确定可能减轻糖尿病风险的特定DMARD或组合.
- 分析这一群体中糖尿病的其他潜在风险因素.
主要方法:
- 这是一项利用长光研究数据库的队列研究.
- 纳入标准:5530名患有RA的成年人,没有先前的糖尿病诊断.
- 终点:新发型糖尿病 (HbA1c ≥7%),分析了单独治疗甲醇,生物DMARDs,MTX组合,其他常规DMARDs和非DMARD时期.
主要成果:
- 在2001年至2018年期间,9.87%的参与者患上了新发糖尿病.
- 与MTX单独治疗相比,生物DMARDs (HR 0.51),MTX组合 (HR 0.50) 和其他常规DMARDs (HR 0.56) 的糖尿病风险明显降低.
- 氧化氨酸显示出一种保护作用 (HR 0.52);TNF-α抑制剂显示出一种保护的趋势 (HR 0.69).
结论:
- 关节炎治疗选择显著影响糖尿病风险.
- 生物DMARDs,组合疗法和某些常规的DMARDs,如氧化可能会在RA患者中提供预防糖尿病的保护.
- 考虑到糖尿病风险的个性化治疗策略是 RA 管理的必要条件.
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