患有类风湿性关节炎的患者中与精神疾病相关的因素启动b/ts DMARDs:基于人口的研究
Hsin-Hua Chen1,2,3,4,5,6, Peng-Yen Wu7, Ching-Heng Lin5,6,8,9,10
1Division of General Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
International journal of rheumatic diseases
|December 7, 2023
概括
患有类风湿性关节炎 (RA) 的患者服用生物和向合成疾病修饰性抗风湿药物 (b/tsDMARDs) 有显著的精神疾病发病率. 与TNFi相比,托西利祖马布,阿巴塔塞普和tsDMARD与较低的风险有关.
科学领域:
- 类风湿病学 类风湿病学
- 精神病学是一个精神病学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 精神健康对类风湿性关节炎 (RA) 患者至关重要,但其在生物和向合成疾病修饰性抗风湿药物 (b/tsDMARDs) 治疗期间的状况尚不清楚.
- 关节炎的治疗需要采用全面的方法,包括监测精神健康以及疾病活动.
研究的目的:
- 确定接受b/tsDMARD治疗的RA患者中新发精神疾病的发生率.
- 确定与这种患者群体中精神疾病发展相关的因素.
主要方法:
- 一项基于人口的队列研究,使用台湾国家健康保险研究数据库 (2001-2020年).
- 包括开始b/tsDMARDs的RA患者,以精神疾病 (焦虑,情绪障碍) 为主要结局.
- 考克斯回归分析以确定风险因素,报告危险比率 (HR) 和95%置信区间 (CI).
主要成果:
- 分析了10,852名RA患者,其中13.62%患有精神疾病 (发病率:每10万人年4054人).
- 与瘤坏死因子抑制剂 (TNFi) 相比,使用托西利祖马布,阿巴塔切普或tsDMARDs的治疗显示精神疾病风险降低.
- 与增加精神疾病风险相关的因素包括年龄较大,低收入,糖尿病和同时使用环素或类固醇.
结论:
- 该研究量化了b/tsDMARDs的RA患者中精神疾病的发病率,强调了其临床相关性.
- 研究结果表明,特定的b/tsDMARDs可能对精神疾病有保护作用,而某些并发症和人口因素会增加风险.
- 对于接受先进治疗的RA患者,建议提高对心理健康问题的警.
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