免疫抑制的使用和随后的癌症发病率:队列研究
Jeanine M Buchanich1, Craig W Newcomb2, Terri L Washington1
1Department of Biostatistics, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA.
BMJ oncology
|January 31, 2025
概括
大多数针对眼部炎症性疾病 (OID) 的免疫抑制疗法并没有增加癌症风险. 需要对特定药物进行进一步的研究,如阿达利穆马布和甲铁,这些药物对癌症发病率有不同的影响.
科学领域:
- 眼科医生 眼科 眼科
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
背景情况:
- 眼部炎症性疾病 (OID) 通常需要免疫抑制治疗.
- 与这些治疗相关的长期癌症风险尚未完全理解.
研究的目的:
- 评估免疫抑制治疗与OID患者癌症发病率之间的关联.
- 确定特定的免疫抑制药物类别和与癌症风险相关的药物.
主要方法:
- 从10个美国实践中 (1996-2015) 对10,872名非传染性OID患者进行了回顾性队列研究.
- 对免疫抑制药物类 (抗代谢物,氨酸抑制剂,化剂,TNF抑制剂) 和特定药物的时间依赖性暴露.
- 癌症发病率通过与12个州癌症登记处的联系来确定.
- 考克斯回归生存分析与0,3年和5年滞后.
主要成果:
- 总体癌症发病率的统计学上显著增加与常见的免疫抑制药物类别无关.
- 特定药物显示出多种相关性:阿达利穆马布和ambucil (在SID队列中) 的危险性降低,tacrolimus和etanercept (非SID队列) 的危险性增加,以及甲状腺素的危险性降低 (两个队列).
- 大多数免疫抑制药物与总体癌症发病率的增加无关.
结论:
- 对OID的短期非移植性免疫抑制疗法通常与癌症风险增加无关.
- 需要进一步的研究来澄清某些药物对癌症发病率的具体影响.
- 这些发现表明大多数免疫抑制剂在OID患者癌症发展方面具有有利的安全性.
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