根据结性脊柱炎患者的生物剂暴露的心血管风险:一项基于全国人口的全国性研究
Oh Chan Kwon1, Hye Sun Lee2, Juyeon Yang2
1Division of Rheumatology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonjuro, Gangnam-Gu, Seoul, 06273, South Korea.
Clinical rheumatology
|November 7, 2024
概括
瘤坏死因子抑制剂 (TNFis) 在结性脊髓炎 (AS) 患者中显著降低了30%的心血管风险. 与没有bDMARDs或TNFis相比,介素-17抑制剂 (IL-17is) 对心血管事件没有显著影响.
科学领域:
- 类风湿病学 类风湿病学
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 结性脊柱炎 (AS) 患者面临心血管事件风险升高的风险.
- 生物修饰性抗风湿药物 (bDMARDs) 对AS有效,但它们对心血管的影响尚不确定.
研究的目的:
- 在AS患者中,评估与瘤坏死因子抑制剂 (TNFis) 和干白素-17抑制剂 (IL-17is) 相关的心血管风险.
- 在不同bDMARDs和非暴露之间比较心血管事件率.
主要方法:
- 从韩国全国数据库 (2010-2021) 中对43,502名AS患者进行了回顾性分析.
- 定义的心血管事件是发生的心肌梗塞或中风.
- 使用时间依赖的考克斯模型来比较TNFis,IL-17is和bDMARD非暴露之间的风险.
主要成果:
- 暴露于TNFis与30%降低心血管事件的风险有关 (aHR=0.697).
- 与bDMARD非暴露相比,IL-17is暴露在心血管风险上没有显著差异 (aHR=0.962).
- 在IL-17is和TNFis之间没有观察到心血管风险的显著差异 (aHR=1.381).
结论:
- 暴露于TNFis与AS患者心血管风险显著降低有关.
- 在AS患者中,IL-17is暴露似乎不会显著改变心血管风险.
- 对于那些担心心心血管风险的AS患者来说,TNFis可能是首选的bDMARD选择.
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