杜皮卢马布和喘患者中的淋巴瘤风险:基于人口的队列研究
Kevin Sheng-Kai Ma1,2, Bethany Brumbaugh3,4,2, Rebecca R Saff4,5,2
1Department of Dermatology, Massachusetts General Hospital, Boston, MA kevinskma1@gmail.com.
The European respiratory journal
|June 19, 2025
概括
在喘患者中,dupilumab治疗显示了淋巴瘤的风险增加,特别是T和NK细胞类型. 然而,它也与明显较低的全因死亡率有关,这表明了复杂的风险-收益概况.
科学领域:
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
- 肺部病理学 肺部病理学
背景情况:
- 杜皮卢马布已被批准用于治疗诸如阿托皮性皮炎和喘等过敏性疾病.
- 以前的研究表明,在接受dupilumab治疗的阿托皮性皮炎患者中,皮肤淋巴瘤的风险可能增加.
- 这项研究调查了用dupilumab治疗的喘患者的淋巴瘤风险.
研究的目的:
- 评估与标准疗法相比,在用dupilumab治疗的喘患者中新发性淋巴瘤的风险.
- 作为二次结果,评估其他恶性瘤的发病率和全因死亡率.
主要方法:
- 2018-2024年美国喘患者的基于人口的队列研究.
- 与使用吸入性皮质类固醇 (ICS) 以及长效β激动剂 (LABA) 的用户进行了对比.
- 使用的倾向性得分与基线差异对照匹配;主要结局是新发性淋巴瘤.
主要成果:
- 分析了14936名杜比卢马布使用者和734126名ICS/LABA使用者.
- 杜皮卢马布与淋巴瘤 (HR=1.79),特别是T和NK细胞淋巴瘤 (HR=4.58) 的更高风险有关.
- 在其他恶性瘤中没有显著差异;dupilumab显示出较低的全因死亡率 (HR=0.65).
结论:
- 在喘患者中,dupilumab治疗与淋巴瘤的风险增加有关,特别是T和NK细胞类型.
- 尽管淋巴瘤风险增加,但dupilumab的使用与所有原因的死亡率降低有关.
- 建议进行进一步的研究和长期监测,以了解与dupilumab相关的淋巴瘤机制.
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