如何COVID-19大流行影响了我们使用生物/向DMARDs的风湿病患者?
Semih Gulle1, Yesim Erez1, Ali Karakas1
1Department of Rheumatology, Dokuz Eylul University School of Medicine, Izmir, Turkey.
Journal of infection in developing countries
|July 29, 2023
概括
在COVID-19大流行期间,大约五分之一的炎症性类风湿性疾病患者推迟了生物或向合成疾病修饰性抗风湿性药物 (b/tsDMARD) 治疗. 然而,在良好的患者沟通的情况下,治疗成功地重新开始,显示出高的12个月药物保留率.
科学领域:
- 类风湿病学 类风湿病学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- COVID-19大流行严重影响了医疗保健和患者管理.
- 服用b/tsDMARDs的炎症性类风湿性肌肉骨疾病 (iRMD) 患者在治疗连续性方面面临着独特的挑战和担忧.
- 了解大流行对iRMD治疗的影响对于保持患者健康和药物疗效至关重要.
研究的目的:
- 调查COVID-19大流行对使用b/tsDMARDs的iRMD患者治疗过程的影响.
- 分析治疗延迟,并确定影响疫情期间药物保留的因素.
- 根据患者的治疗和并发症,评估iRMD患者感染SARS-CoV-2的风险.
主要方法:
- 采用两阶段的研究设计来评估治疗延迟和长期保留.
- 分析了521名iRMD患者的数据,包括诊断 (例如,SPA,RA) 和药物使用 (b/tsDMARDs,氧化,葡萄糖皮质类药物).
- 统计分析,包括危险比率 (HR),用于确定影响药物保留和SARS-CoV-2感染风险的因素.
主要成果:
- 大约20%的接受b/tsDMARDs的iRMD患者由于COVID-19的恐惧,在大流行初期的3个月中推迟了治疗.
- 减少12个月药物保留的因素包括同时使用氧化,IV bDMARD的使用,以及最初的治疗中止.
- 葡萄糖皮质类药物使用和先前存在的间歇性肺病/COPD显著增加了SARS-CoV-2感染风险.
结论:
- 尽管由于与大流行有关的恐惧导致初始治疗延迟,但有效的患者沟通促进了治疗的恢复.
- 观察到高的12个月药物保留率,表明b/tsDMARD治疗在iRMD患者中的弹性.
- 识别SARS-CoV-2感染的风险因素对于在流行病期间保护脆弱的iRMD患者至关重要.
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