抗使用对腹痛和在炎症性肠病中使用阿片类药物的影响:基于人口的研究
Chachrit Khunsriraksakul1,2, Olivia Ziegler3, Dajiang Liu4
1Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland, USA.
Alimentary pharmacology & therapeutics
|April 11, 2025
概括
在炎症性肠病 (IBD) 患者中使用抗药与增加的腹痛和阿片类药物使用有关,特别是在未使用阿片类药物的个体中. 这种药物类别也会增加皮质类固醇使用和医疗保健利用的风险.
科学领域:
- 胃肠病学 胃肠病学
- 临床药理学 临床药理学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 患有炎症性肠病 (IBD) 的患者经常接受治疗慢性腹痛的抗药.
- 然而,关于这些药物的疗效和临床影响的大规模数据是有限的.
研究的目的:
- 调查抗药使用与IBD患者的治疗结果之间的关联.
- 检查的关键结果包括腹痛,阿片类药物使用以及倾向匹配前后的其他临床标志物.
主要方法:
- 利用了TriNetX钻石网络,一个全面的医疗和索赔数据库.
- 患者根据基线腹痛和阿片类药物使用情况进行了分层.
- 二次结局包括皮质类固醇使用,IBD并发症,手术,急诊室访问,住院和死亡率.
主要成果:
- 分析包括85,859名IBD患者;5,661人使用抗药.
- 抗药使用者在治疗后出现更高的腹痛和阿片类药物使用率 (p < 0.001).
- 服用抗性药物的阿片类药物未使用的患者随后使用阿片类药物的可能性显著更高 (1.1%与0.2%相比; p < 0.001).
- 在抗使用者中观察到增加的皮质类固醇使用,诊所访问,急诊访问和住院治疗.
- 在IBD相关的并发症,手术或死亡率方面没有发现显著差异.
结论:
- 在IBD患者中使用抗药与恶化的腹痛和增加的阿片类药物使用有关,特别是在未使用阿片类药物的个体中.
- 抗药与使用皮质类固醇,诊所访问,急诊室访问和住院的可能性更高有关.
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