在使用生物响应修饰剂,皮质类固醇和口服小分子的人群中,发生皮类固醇感染的风险
Debbie L Wilson1, Lili Zhou2, Dominick G Sudano2
1University of Florida, Gainesville.
ACR open rheumatology
|March 1, 2024
概括
生物响应修饰剂 (BRM) 和皮质类固醇显著增加Medicare患者患有自身免疫性疾病的菌菌病的风险. 对于在流行地区服用这些药物的患者,建议对这种真菌感染进行查.
科学领域:
- 类风湿病学 类风湿病学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 生物响应修饰剂 (BRM),皮质类固醇和口服小分子 (OSM) 用于治疗类风湿性和自身免疫性疾病.
- 型菌是一种流行于美国某些地区的真菌感染.
研究的目的:
- 为了调查BRM,皮质类固醇和OSM使用与发展菌菌症的风险之间的关联.
- 为了评估在被诊断患有风湿性或自身免疫性疾病的美国医疗保险受益人中的这种风险.
主要方法:
- 一项回顾性队列研究利用了2011-2016年美国医疗保险索赔数据.
- 鉴定的受益者在菌菌流行地区的风湿性/自身免疫性疾病启动BRMs,皮质类固醇或OSMs.
- 采用时间变化的暴露变量和多变量的Cox比例危险回归与90天的滞后期.
主要成果:
- 在5,065名患有类风湿性/自身免疫性疾病的受益者中,107人被诊断患有菌菌病 (每1000人年6.1).
- 与OSM用户相比,BRM用户的风险明显增加 (aHR 3.94),紧随其后的是皮质类固醇用户 (aHR 2.29).
- 对于OSM使用者来说,菌菌病的发病率与不使用这些药物的患者相似.
结论:
- 在这种医疗保险人群中,菌菌病的发病率很低.
- BRM和皮质类固醇的使用与更高的菌菌症风险有关.
- 建议在特有地区接受BRMs和皮质类固醇治疗的患者进行查.
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