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在亚托皮性皮肤炎中使用JAK抑制剂的心血管和血栓栓风险:全球队列研究
Khalaf Kridin1,2,3, Samer Kridin4, Eliza Mayer2,3
1Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.
概括
与dupilumab和methotrexate相比,亚努斯激酶 (JAK) 抑制剂用于亚托皮炎 (AD) 显示肺栓塞 (PE) 和深静脉血栓塞 (DVT) 的风险略有增加. 在处方JAK抑制剂时,仔细选择患者和进行血栓风险评估至关重要.
科学领域:
- 皮肤病学 皮肤病学
- 心血管安全心血管安全
- 药物监督 药物监督 药物监督
背景情况:
- 简氏激酶 (JAK) 抑制剂越来越多地用于中度至重度的亚托皮炎 (AD).
- 人们对JAK抑制剂的心血管安全存在担忧,特别是血栓栓塞的风险.
- 在AD人群中,现实世界的证据是有限的.
研究的目的:
- 评估心肌梗塞 (MI),中风,肺栓塞 (PE) 和深静脉血栓塞 (DVT) 的真实风险.
- 为了比较在接受JAK抑制剂治疗的阿托皮性皮炎 (AD) 患者中的这些风险与dupilumab,甲醇和环素相比.
主要方法:
- 利用TrinetX全球数据库进行现实世界的回顾性队列研究.
- 进行了三项倾向性得分匹配分析,比较了JAK抑制剂发起者与dupilumab,甲醇或环素使用者.
- 在3年的随访期内评估了心脏病发作,中风,PE和DVT的发生率.
主要成果:
- 与dupilumab相比,JAK抑制剂与PE (HR 2.75) 和DVT (HR 2.54) 的风险明显增加有关.
- 与JAK抑制剂相比,甲铁酸的使用观察到严重增加的DVT风险 (HR 2.41).
- 与任何比较药物相比,没有发现JAK抑制剂对心脏病发作或中风风险的统计显著增加.
结论:
- 使用JAK抑制剂的亚托皮炎 (AD) 患者面临的肺栓塞 (PE) 和深静脉血栓塞 (DVT) 的风险略高,相比于使用杜皮卢马布或甲铁的患者.
- 这些发现强调了明智的患者选择的重要性.
- 在治疗阿尔茨海默病时使用JAK抑制剂之前和期间,对血栓形成风险进行评估至关重要.
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