在SLE中使用真实世界口服葡萄皮质类药物:使用法国医疗行政 (SNDS) 索赔数据库进行全国性基于人口的研究
Laurent Arnaud1, Caroline Fabry-Vendrand2, Remus Todea2
1Service de Rhumatologie, Hôpitaux Universitaires de Strasbourg, Centre National de Référence des Maladies Systémiques Auto-immunes Rares Est Sud-Ouest, INSERM UMRS-1109, Université de Strasbourg, Strasbourg, France laurent.arnaud@chru-strasbourg.fr.
Lupus science & medicine
|February 18, 2025
概括
2019年,近一半的法国系统性红斑狼 (SLE) 患者使用了口服皮质糖类药物 (OCS),较高剂量与并发症增加有关. 这凸显了在SLE管理中需要OCS节省策略的需要.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 公共卫生 公共卫生
背景情况:
- 口服葡萄皮质类药物 (OCS) 对于系统性红斑狼 (SLE) 是至关重要的,但会造成严重的伤害.
- 在国家SLE人口中使用OCS的现实数据有限.
- 这项研究分析了法国的OCS使用率和SLE治疗模式.
研究的目的:
- 评估在法国全国性全身性红斑狼 (SLE) 患者群体中口服葡萄糖皮质体 (OCS) 的实际使用情况.
- 分析OCS剂量与使用其他SLE治疗方法之间的关联.
- 评估SLE患者与OCS相关并发症的风险.
主要方法:
- 使用法国医疗保险索赔数据库 (大约. 6600万个体). 这种情况的确存在.
- 在2019年确定了流行SLE患者 (ICD-10代码M32).
- 通过药房药物配送捕获的SLE治疗和计算的平均每日OCS剂量 (普雷尼松等效).
主要成果:
- 2019年,确定了31,852名SLE患者 (86.3%为女性,平均年龄为49.7).
- 48.3%的SLE患者接受了OCS;12.4%使用平均每日剂量>5mg.
- 较高的OCS剂量与增加使用其他SLE治疗 (p<0.0001) 和OCS并发症 (心血管,感染,骨质疏松症) (p<0.0001) 相相关.
- 值得注意的是,13.6%的接受OCS>5毫克/天的患者没有服用抗疟疾药物,免疫抑制剂或生物药物.
结论:
- 48.2%的法国SLE患者在2019年使用了OCS,其中12.4%的平均剂量>5毫克/天.
- 增加OCS使用与更高的并发症风险和其他SLE疗法的不足利用有关.
- 对于有效的SLE管理,需要紧急实施OCS节约策略.
相关概念视频
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
92
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
92
Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
213
Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
213
Oral Hypoglycemic Agents: α-Glucosidase Inhibitors
144
α-glucosidase inhibitors, including acarbose (Precose), miglitol (Glyset), and voglibose (Voglib) (primarily available in Asia), are drugs that control blood sugar levels by delaying the digestion of starch and disaccharides. They achieve this by inhibiting α-glucosidase enzymes in the intestine, which slow the absorption of carbohydrates in the intestine, which in turn leads to a prolonged release of the glucoregulatory hormone GLP-1 from intestinal L-cells.
Acarbose and miglitol are...
Acarbose and miglitol are...
144
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
135
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
135
Glucagon-like Receptor Agonists
291
Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
291
Drug Dosage Regimen: Overview
3.4K
A drug dosage regimen describes the specific instructions and schedule for administering a drug to a patient. It considers factors such as drug dosage, frequency, route of administration, and duration of treatment. Designing an appropriate dosage regimen for a patient aims to achieve a target drug concentration at the site of action.
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...
3.4K


