低剂量甲甲和严重的不良事件在慢性病的老年人中
Flory T Muanda1,2,3, Peter G Blake4, Matthew A Weir1,3
1ICES Western, London, Ontario, Canada.
JAMA network open
|November 27, 2023
概括
低剂量甲状腺与氧化相比,增加了慢性病 (CKD) 的老年人严重不良事件. 这一发现需要仔细考虑甲状腺酸盐.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 类风湿病学 类风湿病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 低剂量甲状腺素是一种常见的治疗类风湿性关节炎和牛皮.
- 它的脏分泌突显了在慢性病 (CKD) 患者中需要安全数据的需要.
研究的目的:
- 为了比较90天严重不良事件 (SAE) 的风险,在老年人中,CKD开始低剂量甲状腺素与氧化.
- 为了评估不同低剂量甲状腺素治疗方案的SAE风险,并将其与氧化基因进行比较.
主要方法:
- 一个回顾性,基于人口的,新用户队列研究在安大略省,加拿大 (2008-2021).
- 包括66岁以上的患有慢性病的成年人 (eGFR<60毫升/分钟/1.73米2,不接受透析).
- 倾向性得分匹配被用来比较2309名甲基酸盐使用者与2309名氧化使用者,分析90天内的SAE.
主要成果:
- 开始低剂量甲状腺素 (3.55%) 的患者,相比于氧化 (1.73%) (RR,2.05) 的患者,90天的SAE风险显著更高.
- 随着较低的eGFR类别,SAE的风险逐渐增加.
- 15-35毫克/周的甲索特雷克萨特剂量与与氧化相比更高的SAE风险相关.
结论:
- 与那些开始用基的老年人相比,在90天内开始使用低剂量甲状腺素的老年人经历了更高的严重不良事件风险.
- 这些发现表明,在CKD患者中低剂量甲状腺素的风险需要仔细平衡其治疗益处.
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