患有牛皮的风险与免疫检查点抑制剂
Sheng-Yin To1,2,3, Cho-Hao Lee4, Yi-Hsien Chen5
1Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan.
JAMA dermatology
|November 6, 2024
概括
接受免疫检查点抑制剂 (ICI) 治疗癌症的患者患上牛皮的风险显著增加. 在癌症治疗期间,医疗保健提供者应监测这种与免疫相关的不良事件.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 皮肤病学 皮肤病学
背景情况:
- 免疫检查点抑制剂 (ICI) 是有效的癌症疗法.
- ICI可以引起与免疫相关的不良事件,包括自身免疫性疾病.
研究的目的:
- 为了研究ICI治疗的癌症患者牛皮发育的风险.
- 为了比较ICI用户和非ICI用户之间的牛皮发病率.
主要方法:
- 全国范围的队列研究使用台湾国家健康保险和癌症登记数据.
- 目标试验模拟设计,包括135230名癌症患者 (III-IV阶段).
- 用于分析的治疗权重和Cox/Fine-Gray模型的逆概率.
主要成果:
- 与非ICI用户 (1.44每1000人年) 相比,ICI用户的牛皮发病率更高 (5.76每1000人年).
- 使用ICI与牛皮风险增加2倍相关 (IPTW调整HR,3.31).
- 在不同的研究设计和敏感性分析中,结果一致.
结论:
- 用ICI治疗的癌症患者患上牛皮的风险较高.
- 对这种风险的认识对于临床医生管理免疫治疗的癌症患者至关重要.
- 对皮肤学不良事件的监测对于最佳的患者护理至关重要.
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