德诺苏马布和现实世界的死亡率:一项比较研究
Dunia Alarkawi1, Thach Tran1, Weiwen Chen1,2
1Skeletal Diseases Program, Garvan Institute of Medical Research, University of New South Wales, Sydney, Australia.
概括
德诺苏马布 (Dmab) 降低了骨折后女性的死亡率,但与双酸盐 (BPs) 相比,在没有骨折的男性和女性中增加了死亡率. 口服BP持续降低骨折患者的死亡率.
科学领域:
- 骨代谢和骨质疏松症研究研究
- 药监和药物安全 药监和药物安全
- 流行病学和公共卫生.
背景情况:
- 德诺苏马布 (Dmab) 是一种广泛使用的骨质疏松症治疗方法,但它对全因死亡率的影响,特别是与双酸盐 (BPs) 相比,需要进一步调查.
- 目前对Dmab的死亡率影响的研究是有限的,特别是在多种不同的人群和骨折环境中.
研究的目的:
- 调查Dmab使用与与没有治疗相比,骨折患者的全因死亡率之间的关联.
- 为了检查与BP (口服BP和zoledronic acid) 相比,在没有骨折的个体中,Dmab使用和全因死亡率之间的联系.
主要方法:
- 使用倾向-得分匹配的新用户队列设计应用于前性,基于人口的45和Up研究 (n=267,357) 的数据.
- 数据链接包括住院情况,药物记录和安全的研究环境访问.
- 用性别特定的多变量Cox模型来评估匹配的队列中的死亡风险.
主要成果:
- 在骨折队列中,Dmab与女性的死亡率明显降低有关 (HR=0.52),但男性没有,而口服BP则减少了两性死亡率 (HR=0.56).
- 在没有骨折的队列中,Dmab与与口服BP相比的1.5至2.5倍高的死亡率有关,但与zoledronic acid的死亡率相似.
- 妇女使用Dmab和口服BP使用与骨折后死亡率降低有关.
结论:
- 德诺苏马布在骨折后对女性的死亡率有好处,类似于口服双酸盐.
- 在没有骨折的个体中,与口服双酸盐相比,Dmab的使用与全因死亡率的增加有关,因此需要仔细考虑风险和益处的概况.
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