双酸盐在肝硬化患者中的有效性:一个模拟的临床试验
Elliot B Tapper1, Beanna Martinez1, Peter Jepsen2,3
1Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA.
Alimentary pharmacology & therapeutics
|June 26, 2024
概括
双酸盐显著减少了老年肝硬化和骨质疏松症患者的整体骨折. 增加药物使用和药物坚持对于预防脆弱人群中骨折至关重要.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 老年病的医生 老年病的医生
- 药理学 药理学是指药理学的学科.
背景情况:
- 跌倒和骨折是肝硬化患者的重大并发症.
- 双酸盐推用于骨质疏松症,但缺乏关于它们在肝硬化患者中的有效性的具体数据.
研究的目的:
- 模拟一项临床试验,评估双酸在肝硬化患者中的有效性.
- 评估双酸盐对肝硬化和骨质疏松症患者骨折风险的影响.
主要方法:
- 利用国家医疗保险数据从2008年至2020年为新用户设计.
- 使用治疗权重的逆概率来平衡患者组.
- 分析了治疗意图和治疗效应,以及对照暴露和结果,以确保因果有效性.
主要成果:
- 在治疗意图分析中,双酸盐显著减少了整体骨折 (27.5%与33.0%,p=0.0004).
- 在65岁以下的患者,男性和非酒精相关肝病患者中,骨折减少值得注意.
- 当处理时的分析显示,累积的双酸盐暴露减少了骨折 (sHR 0.95).
结论:
- 双酸盐在老年肝硬化患者中减少整体骨折方面表现出有效性.
- 需要改善双酸盐的摄入量,并确保在这个患者群体中持续持续使用药物.
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