德诺苏马布的使用可以降低骨质疏松症患者的类风湿性关节炎风险
Chun-Hsiung Chen1, Hsien-Tzung Liao2, Hung-An Chen3
1Division of Allergy, Immunology and Rheumatology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taiwan, and School of Medicine, Tzu Chi University, Hualien, Taiwan.
Clinical and experimental rheumatology
|January 5, 2024
概括
骨质疏松症药物,特别是登苏马布,在患有骨质疏松症的患者中显著降低了类风湿性关节炎 (RA) 风险. 这表明骨健康和RA发展之间存在联系,可能涉及RANKL途径.
科学领域:
- 类风湿病学 类风湿病学
- 骨质疏松症研究 骨质疏松症研究
- 药理学 药理学是指药理学的学科.
背景情况:
- 类风湿性关节炎 (RA) 和骨质疏松症是常见的疾病,特别是在老年人群中.
- 了解骨质疏松症和RA风险之间的相互作用对于全面的患者护理至关重要.
- 现有研究尚未完全阐明骨质疏松症药物对RA发展的潜在保护作用.
研究的目的:
- 调查骨质疏松症药物的保护作用对发展类风湿性关节炎 (RA) 的风险.
- 评估特定的骨质疏松症药物的影响,包括双酸盐,德诺苏马布,拉洛西芬和特里巴胺,对RA风险.
- 通过药物类型,性别和使用模式来分层降低RA风险.
主要方法:
- 从2011年1月到2023年3月,在台湾的医院人口中进行了一项回顾性队列研究.
- 包括17065名患有骨质疏松症的患者,比较了7180名药物使用者与9605名不使用者.
- 分析了RA风险,按性别和特定的骨质疏松症药物分层,并对共变量进行调整.
主要成果:
- 骨质疏松症药物使用与RA风险降低有关 (aHR=0.484,p<0.05).
- 双酸盐和德诺苏马布显著降低了RA风险 (分别为aHR=0.405和aHR=0.394).
- 德诺苏马布单一治疗显示进一步降低了RA风险 (aHR=0.32),特别是在女性患者中 (aHR=0.26). 拉洛西芬和特里巴拉提德没有显著影响.
结论:
- 在被诊断患有骨质疏松症的患者中,使用denosumab显著降低了类风湿性关节炎的风险.
- 这些发现表明,参与骨质细胞活动的核因子卡帕B连接体 (RANKL) 途径的受体激活器可能在RA的发病过程中发挥作用.
- 准RANKL可能是预防风险骨质疏松症患者的RA的潜在治疗策略.
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