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与对照组相比,在接受免疫调节治疗的炎症性关节炎患者中,严重感染的长度风险相比,对照组的风险相比
Ingrid Egeland Christensen1,2, Siri Lillegraven1, Joseph Sexton1
1Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway.
Rheumatology advances in practice
|March 10, 2025
概括
与一般人群相比,发炎性关节炎 (IA) 患者开始使用生物/向性合成DMARD (b/tsDMARD) 面临更高的严重感染风险. 这种感染风险在不同的治疗开始期和整个治疗过程中保持一致.
科学领域:
- 类风湿病学 类风湿病学
- 传染病流行病学 传染病流行病学
- 药物监督 药物监督 药物监督
背景情况:
- 生物和向合成DMARDs (b/tsDMARDs) 对于治疗炎症性关节炎 (IA) 是至关重要的.
- 了解与启动这些疗法相关的严重感染风险对于患者安全至关重要.
- 需要对一般人群和不同IA诊断的风险数据进行比较.
研究的目的:
- 为了比较IA患者开始第一次b/tsDMARD的12个月严重感染风险与一般人群.
- 分析b/tsDMARD治疗期间在不同IA诊断 (风湿性关节炎,牛皮性关节炎,脊髓关节炎) 中感染风险的发展.
- 检查整个b/tsDMARD治疗过程中的感染风险动态.
主要方法:
- 前性队列研究 (NOR-DMARD) 包括4309名IA患者 (RA,PsA,SpA) 和86,640名一般人群对照.
- 考克斯回归分析用于在三个启动时间队列 (2009-2011,2012-2014,2015-2018) 中比较12个月的严重感染风险.
- 在b/tsDMARD治疗期间,每6个月间隔至24个月进行风险评估.
主要成果:
- 与对照组相比,开始接受b/tsDMARD的IA患者在12个月内患有严重感染的风险更高 (RA:HR 2.42;PsA/SpA:HR 1.91).
- 在b/tsDMARD开始的时间队列之间没有观察到12个月感染风险的显著差异.
- 牛皮关节炎/脊椎关节炎患者的感染风险低于类风湿性关节炎患者; 风险在治疗期间保持稳定.
结论:
- 在2009年至2018年期间,IA患者开始接受首次b/tsDMARD治疗时,与普通人群相比,他们始终面临更高的严重感染风险.
- 严重感染的风险在不同的启动时间队列或治疗过程中没有变化.
- 这些发现凸显了与IA患者的b/tsDMARDs相关的持续感染风险,无论治疗的开始期或持续时间如何.
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