托桑多硫酸盐黄斑病的风险和剂量反应关系:系统性审查和元分析
Brendan K Tao1, Korolos Sawires2, Kate Lim2
1Department of Ophthalmology & Vision Science, University of Toronto, Toronto, Ontario, Canada.
Ophthalmology. Retina
|March 12, 2025
概括
托桑聚硫酸盐红斑病变 (PPSM) 的风险随着托桑聚硫酸盐 (PPS) 的累积剂量增加而增加. 这一元分析证实了剂量与反应的关系,强调需要仔细监测患者和剂量管理.
科学领域:
- 眼科医生 眼科 眼科
- 药物监督 药物监督 药物监督
- 视网膜疾病 视网膜疾病
背景情况:
- 松聚硫酸 (PPS) 用于各种疾病,但其与黄斑病 (PPSM) 的关联越来越令人担忧.
- 现有的观察性研究表明PPS剂量与黄斑病风险之间存在联系,但缺乏综合分析.
研究的目的:
- 进行系统性审查和元分析,以确定托桑聚硫酸黄斑病 (PPSM) 的汇总相对风险 (RR).
- 为了建模累积松聚硫酸 (PPS) 剂量与发展PPSM的风险之间的剂量反应关系.
主要方法:
- 对报告PPSM发生率和累计PPS剂量的研究进行系统审查和元分析.
- 搜索了Medline,Embase和Cochrane控制试验的中央注册表,截至2024年9月15日.
- 包括5项涉及141,785名患者和6432例PPSM病例的研究;评估偏差风险.
主要成果:
- 一个线性剂量反应模型表明,每克累计PPS剂量增加的每克RR增加0.1%的黄斑病变.
- 累计剂量≥2000克的患者与未暴露的患者相比,RR为7.39 (95% CI,4.17-13.10).
- 即使是较低的剂量 (1-500克) 也显示RR增加为1.65 (95% CI,1.12-2.43).
结论:
- 中等确定性证据支持PPS暴露和PPSM风险之间的剂量依赖关系.
- 更高的累积PPS剂量显著提高了黄斑病变的风险.
- 建议包括逐渐将PPS降至最低有效剂量,并实施定期查黄斑病,特别是对于高累积剂量患者.
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