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牙周炎是一种与免疫检查点抑制剂相关的免疫相关不良事件:一个多中心队列研究

Kevin Sheng-Kai Ma¹, Cho-Hung Chiang², Steven T Chen³

¹Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

|July 5, 2024

概括

免疫检查点抑制剂 (ICI) 显著增加患牙周炎的风险,这是一个严重的口腔健康并发症. 这种与免疫相关的不良事件与改善癌症生存结果有关.

科学领域:

在瘤学瘤学.
免疫学免疫学免疫学
牙周病学牙周病学
口腔医学是指口腔医学.

背景情况:

免疫检查点抑制剂 (ICI) 是关键的癌症疗法,可以触发与免疫相关的不良事件 (irAEs).
口腔并发症,包括口腔干燥和口腔炎,已知与ICI治疗相关的irrAEs.
接受ICI治疗的患者患有牙周炎的特定风险及其与其他irAEs的关联需要进一步调查.

研究的目的:

确定使用免疫检查点抑制剂 (ICI) 治疗成人癌症患者牙周炎的风险.
调查ICI相关牙周炎和其他免疫相关不良事件 (irAEs) 之间的关联.
评估与免疫相关的牙周炎对癌症存活率的影响.

主要方法:

从2010年1月到2021年11月,对成年癌症患者进行了一项回顾性队列研究.
接受ICI (PD-1,PD-L1,CTLA-4抑制剂) 的患者的倾向性得分与未接受ICI的对照组相匹配.
牙周炎的发生是主要结果,使用Cox比例危险模型和Kaplan-Meier生存分析进行分析.

主要成果:

牙周炎的发病率在ICI组 (55.3每100个患者年) 比非ICI组 (25.8每100个患者年) 高得多,发病率比率为2.14.
两种PD-L1抑制剂 (HR=2.5) 和PD-1抑制剂 (HR=2.0) 独立地与牙周炎的风险增加有关.
患有免疫相关牙周炎的患者表现出明显更好的整体存活率 (未达到 vs. 17 个月) 和无进展存活率 (14.9 vs. 5.6 个月),并具有更多的同时发生的皮肤IRAE.

结论:

免疫检查点抑制剂 (ICI) 治疗与患牙周炎的风险大大增加有关.
作为一种irAE,免疫相关的牙周炎与改善癌症存活率和其他皮肤irAE的存在有关.
临床医生应监测接受ICI治疗的患者的口腔健康并发症,特别是牙周炎.

关键词:

抗编程细胞死亡1疗法抗编程细胞死亡联体1疗法.免疫检查点抑制剂免疫检查点抑制剂与免疫相关的不良事件.总体生存率总体生存率牙周病是指牙周病的发生.

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