在慢性炎症性皮肤疾病患者推的治疗前测试的发生率
Maria C Schneeweiss1,2,3, Denys Shay1,4, Sophia Ly2
1Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
JAMA dermatology
|January 31, 2024
概括
开始使用免疫调节剂的慢性炎症性皮肤病患者的治疗前实验室检测通常低于推水平,特别是结核病和肝炎查. 需要进一步的研究来评估这些测试变异对患者结果的影响.
科学领域:
- 皮肤病学 皮肤病学
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 系统性免疫调节剂对于治疗慢性炎症性皮肤疾病 (CISD) 至关重要.
- 在开始这些疗法之前,建议对结核病和肝炎等疾病进行治疗前查.
- 目前在美国推的查模式尚不清楚.
研究的目的:
- 确定在开始免疫调节治疗的CISD (牛皮,性炎,亚托皮性皮炎) 患者中推的治疗前检测的流行率.
- 分析结核病,肝炎,完整血细胞计数和脂质面板的检测模式.
主要方法:
- 2002年至2020年美国商业保险索赔数据的描述性分析.
- 包括患有CISD的成年患者,这些患者开始使用特定的免疫调节剂 (甲托雷克萨特,TNFα抑制剂,IL-17Ai,乌斯特基努马布,IL-23i,dupilumab,apremilast).
- 在治疗开始前6个月内和开始治疗后2年内评估查测试比例.
主要成果:
- 分析了超过122,000名患者.
- 全血细胞计数是最常见的测试 (41%-69%).
- 在治疗前,11%-59%的患者进行了结核病查,在1年随访后的比例较低 (3%-26%).
- 在治疗前,13%-41%的患者进行了肝炎面板查.
- 对阿普雷米拉斯和杜皮卢马布的治疗前测试率较低,持续到治疗的第一年.
结论:
- 在美国,在开始全身免疫调节治疗之前,不到60%的CISD患者接受了推的治疗前查.
- 结核病和肝炎的检测率低于最佳水平.
- 需要进一步调查,以了解这些测试变异对患者结果的临床影响.
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