加拿大不列颠哥伦比亚省疾病修饰药物,多发性硬化症和感染相关的医疗保健使用:基于人口的研究
Jonas Graf1, Huah Shin Ng1,2, Feng Zhu1
1Department of Medicine, Division of Neurology and the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada.
Lancet regional health. Americas
|January 25, 2024
概括
在多发性硬化症 (MS) 中使用疾病修饰药物 (DMD) 与需要住院或医生访问的感染减少有关. 然而,DMD治疗与更多与感染相关的处方有关,这需要进一步调查患者的治疗结果.
科学领域:
- 神经学 神经学
- 药理流行病学 药理流行病学
- 公共卫生 公共卫生
背景情况:
- 关于多发性硬化症 (MS) 疾病修饰药物 (DMD) 和它们对感染相关医疗保健使用的影响的现实数据仍然有限.
- 了解这些关联对于优化多发性硬化症管理和患者安全至关重要.
研究的目的:
- 调查DMD暴露与患有多发性硬化症的个体感染相关的医疗利用之间的关联.
- 为了比较DMD暴露和未暴露期间之间的医疗保健使用模式 (住院治疗,医生索赔,处方).
主要方法:
- 在加拿大不列颠哥伦比亚省 (1996-2017) 进行的一项回顾性队列研究包括了19,360名患有MS的人.
- 通过负双项和比例平均回归模型分析了医疗保健利用数据,并对多个共变量进行了调整.
- 结果包括与感染有关的住院,医生索赔和处方填充,报告为调整率比率 (aRR) 和危险比率 (aHR).
主要成果:
- 暴露于DMD与感染相关的医生索赔率降低 (aRR=0.88) 和住院住院风险降低 (aHR=0.64) 相关.
- 相反,DMD使用与较高的感染相关处方率相关 (aRR=1.14).
- 具体发现因DMD施用途径而异,口服DMD显示出最显著的住院风险降低 (aHR=0.54).
结论:
- 多发性硬化症患者的疾病修饰药物暴露与与感染相关的医疗保健利用模式的改变有关.
- 虽然住院和医生因感染的访问减少,但处方率增加.
- 需要进一步的研究,以了解这些观察到的医疗保健使用差异对患者结果的临床影响.
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