在以前患有恶性病变的类风湿性关节炎患者中,阿塔巴塞普的疗效和安全性
Yosuke Kunishita1,2, Kento Ichikawa3, Yuji Uzawa4
1Department of Rheumatology, Yokohama Minami Kyosai Hospital, 1-21-1 Mutsuurahigashi, Kanazawa-Ku, Yokohama, Kanagawa 236-0037, Japan.
Therapeutic advances in musculoskeletal disease
|August 4, 2023
概括
阿巴切 (ABT) 对于类风湿性关节炎 (RA) 患者来说是安全有效的,即使是那些有恶性瘤病史的人. 这项研究发现,在此前因癌症接受过治疗的RA患者中,新癌症的风险增加或继续治疗的差异没有出现.
科学领域:
- 类风湿病学 类风湿病学
- 在瘤学瘤学.
- 临床药理学 临床药理学
背景情况:
- 阿巴 (ABT) 是一种用于治疗类风湿性关节炎 (RA) 的生物疗法,与其他生物药物相比,其感染风险较低.
- 虽然在老年RA患者中有效和安全,但关于ABT对恶性瘤的影响的报告不一致,这些恶性瘤在老年人中更为普遍.
- 恶性瘤是老年RA患者的一个重大问题,原因是它们的发病率增加和对预后的影响.
研究的目的:
- 评估Abatacept (ABT) 在类风湿性关节炎 (RA) 患者的疗效和安全性,这些患者先前有恶性病史.
- 为了在现实临床环境中比较接受ABT的RA患者与没有恶性病史的RA患者的结果.
主要方法:
- 一项多中心的回顾性研究包括312名接受ABT治疗的RA患者.
- 患者被分为两组:没有先前恶性瘤 (NP) 的患者和先前有恶性瘤 (PM) 的患者.
- 倾向性得分匹配用于根据年龄,甲状腺素使用,斯坦布罗克阶段,吸烟史,间歇性肺病,疾病持续时间,性别和炎症状况等因素对比组.
主要成果:
- 在对关键因素进行匹配后,PM和NP组之间没有观察到Abatacept延续率或新恶性瘤发病率的显著差异.
- 即使在进一步匹配已知的恶性瘤风险因素后,这些发现仍然是一致的.
- 该研究包括73名有恶性瘤病史的患者,并进行倾向性得分匹配,以确保可比性组.
结论:
- 阿巴cept (ABT) 在有恶性病史的风湿性关节炎患者和没有恶性病史的患者中表现出可比的疗效和安全性.
- 临床实践支持在RA患者中使用ABT,这些患者先前患有恶性瘤,但没有发现新癌症的风险增加.
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