在未被诊断的常见可变免疫缺陷患者中评估药物处方模式
Frederik V Ilkjær1,2, Isik S Johansen3, Raquel Martin-Iguacel3
1Department of Infectious Diseases, Odense University Hospital, J.B. Winsløws Vej 4, Odense, Denmark. Frederik.veitland@gmail.com.
Journal of clinical immunology
|October 13, 2023
概括
被诊断为常见变性免疫缺陷 (CVID) 的患者在诊断前使用了更多的抗生素,全身类固醇和吸入药物. 这表明这些药物使用可能表明CVID的风险更高.
科学领域:
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
- 流行病学 流行病学
背景情况:
- 常见变性免疫缺陷 (CVID) 是一种主要免疫缺陷,其特征是抗体产生受损.
- 早期诊断CVID对于及时管理和改善患者结果至关重要.
- 在初级保健机构中识别潜在的诊断标记是必不可少的.
研究的目的:
- 为了比较抗生素,全身类固醇和吸入式支气管扩展剂/葡萄皮类固醇在常见变性免疫缺陷 (CVID) 诊断前三年的消费.
- 评估药物消费水平与随后CVID诊断的风险之间的关联.
主要方法:
- 通过使用1994-2014年丹麦国家注册表进行了嵌套病例控制研究.
- 130名被诊断患有CVID (病例) 的个人与5850名人口对照进行了匹配.
- 药物消耗量化为每人-年定义的每日剂量,使用条件后勤回归分析.
主要成果:
- 与对照人群相比,在诊断前三年内,CVID患者的抗生素,全身类固醇和吸入式支气管扩展剂/葡萄皮质类固醇消耗显著增加.
- 在使用这三类药物与随后的CVID诊断风险之间发现了统计学上显著的关联.
- 更高的药物消费和更短的诊断时间与更强的关联相关.
结论:
- 过度使用抗生素,全身类固醇和吸入药物在CVID诊断之前.
- 这些药物的初级保健处方模式可能为主动的CVID查提供机会.
- 需要进行进一步的研究,以建立公共卫生政策整合的处方切断线.
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